Impact of hysteroscopic transcervical resection of uterine septum on the cumulative live birth rate of IVF/ICSI in patients with partial uterine septum
10.3760/cma.j.cn101441-20241202-00455
- VernacularTitle:宫腔镜下子宫纵隔切除术对子宫不全纵隔患者IVF/ICSI累积活产率的影响
- Author:
Zhuolun SU
1
;
Yichun GUAN
1
;
Nan MENG
1
;
Wenjing LI
1
;
Ninghua XU
1
;
Shuang YU
1
;
Hua LOU
1
Author Information
1. 郑州大学第三附属医院生殖医学中心，郑州 450052
- Publication Type:Journal Article
- Keywords:
Fertilization in vitro;
Embryo transfer;
Uterine septum;
Hysteroscopic transcervical resection of uterine septum;
Cumulative live birth rate
- From:
Chinese Journal of Reproduction and Contraception
2025;45(5):468-474
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate whether hysteroscopic transcervical resection of septum (TCRS) prior to in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) can improve cumulative live birth rates in patients with uterine septum. Methods:A retrospective cohort study was conducted to analyze data from 244 patients with partial uterine septum who underwent IVF/ICSI at the Reproductive Medicine Center of the Third Affiliated Hospital of Zhengzhou University between January 2016 and August 2022. The patients were divided into a surgical group ( n=171) and a non-surgical group ( n=73) based on whether TCRS was performed prior to IVF/ICSI. The clinical outcomes of IVF/ICSI in the two groups were analyzed, with the primary observation indicator being the cumulative live birth rate. Cox regression analysis was employed to identify determinants. Results:The age of patients in the operated group [(31.20±3.80) years] was younger than that in the non-operated group [(32.92±5.34) years, P=0.005], and the basal antral follicle count [17.0 (11.0, 24.0)] was higher than that in the non-operated group [14.0 (8.0, 21.5), P=0.039]. There were no significant differences in other baseline data (all P>0.05). The cumulative pregnancy rate [79.53% (136/171)] and the cumulative live birth rate [60.23% (103/171)] in the operated group during the 24-month follow-up period were significantly higher than those in the non-operated group [65.75% (48/73), P=0.022; 45.21% (33/73), P=0.030]. Compared with the operated group [296.0 (260.0, 430.0) d], the duration from the start of ovarian stimulation to the first live birth was significantly prolonged in the non-operated group [379.0 (329.5, 471.5) d, P<0.001]. Adjusted Cox-regression analysis showed that whether or not surgery was performed ( HR=1.683, 95% CI: 1.116-2.539, P=0.013) and the basal antral follicle count ( HR=1.032, 95% CI: 1.000-1.065, P=0.048) were independent factors affecting cumulative live birth rate. Conclusion:Performing TCRS before IVF/ICSI can improve cumulative live birth rates of patients with uterine septum.
