Influence of previous caesarean section on reproductive outcomes of in vitro fertilization and embryo transfer: a meta-analysis
10.3760/cma.j.cn101441-20221009-00439
- VernacularTitle:剖宫产史对体外受精-胚胎移植妊娠结局影响的meta分析
- Author:
Jinli DING
1
;
Feng ZHANG
1
;
Tailang YIN
1
;
Jing YANG
1
Author Information
1. 武汉大学人民医院生殖医学中心 湖北省辅助生殖与胚胎发育临床研究中心，武汉430060
- Publication Type:Journal Article
- Keywords:
Cesarean section;
Fertilization in vitro;
Embryo transfer;
Pregnancy outcome;
Previous cesarean scar defect
- From:
Chinese Journal of Reproduction and Contraception
2023;43(6):573-582
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To systematically evaluate the effect of previous cesarean section (CS) on pregnancy outcome of in vitro fertilization and embryo transfer (IVF-ET). Methods:PubMed, Web of Science, Cochrane Library, Embase, Ovid, Wanfang database, CNKI, VIP database and CBM were searched from inception to August 2022 to collect studies about the effect of CS on pregnancy outcome of IVF-ET. Meta-analysis was performed by Stata16.0 software after information extraction.Results:A total of 20 studies involving 24 753 patients were included. Meta-analysis displayed that the implantation rate, the clinical pregnancy rate and the live birth rate of CS group were significantly lower than those of vaginal delivery (VD) group ( OR=0.79, 95% CI: 0.66-0.95, P=0.013; OR=0.72, 95% CI: 0.63-0.83, P<0.001; OR=0.73, 95% CI: 0.64-0.83, P<0.001), accompanied by increased early abortion rate ( OR=1.18, 95% CI: 1.07-1.30). The results of subgroup analysis showed that compared with VD group, the implantation rate, the clinical pregnancy rate and the premature birth rate of patients with previous cesarean scar defect (PCSD) were significantly reduced ( OR=0.47, 95% CI: 0.31-0.73, P=0.001; OR=0.47, 95% CI: 0.30-0.72, P=0.001; OR=0.41, 95% CI: 0.26-0.65, P<0.001), while the early abortion rate was significantly increased ( OR=2.38, 95% CI: 1.12-5.09, P=0.023). Conclusion:CS significantly reduced the implantation rate, the clinical pregnancy rate and the live birth rate of IVF-ET, and increased the early abortion rate, which might be associated with PCSD. However, due to the quantity and quality of the included studies, the above conclusion needs to be verified by more large-sample and high-quality studies.
