Skip to main content
Erschienen in: Journal of Assisted Reproduction and Genetics 4/2015

01.04.2015 | Assisted Reproduction Technologies

Perinatal outcomes in singleton and twin ICSI pregnancies following hysteroscopic correction of partial intrauterine septa

verfasst von: Kemal Ozgur, Hasan Bulut, Murat Berkkanoglu, Kevin Coetzee

Erschienen in: Journal of Assisted Reproduction and Genetics | Ausgabe 4/2015

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To investigate the perinatal outcomes of patients with clinical pregnancies from ICSI treatments who had previously undergone hysteroscopic surgery to correct partial intrauterine septa and compare them to outcomes of patients with no intrauterine anomalies.

Method

A retrospective observational analysis of 2024 ultrasound confirmed pregnancies from ICSI treatments performed between January 2005 and June 2012. The patients were grouped according to their intrauterine status, and sub-grouped according to the number of fetal hearts observed; singleton control (n = 1128), twin control (n = 566), singleton septum (n = 217) and twin septum (n = 113). The primary outcomes analyzed were miscarriage, preterm, very preterm, stillbirth, vanishing twin and live delivery rates, as well as low birth weight and very low birth weight rates.

Result(s)

The live birth rate (89,9 %) in the singleton control subgroup was non-significantly higher than the live birth rate (85,3 %) in the septum subgroup, with a RR of 1,05 (p = 0,0583, 95 % CI 0,9943–1,1182) for live birth. In contrast the live birth rate (91,3 %) in twin control subgroup was significantly higher than the live birth rate (84,1 %) in the septum subgroup, with a RR 1,09 (p = 0,0282, 95 % CI 0,9988–1,1819). Non-significantly, higher miscarriage and stillbirth rates were the main contributors to the reduced live birth rates. The singleton and twin septum subgroups also had higher rates of premature and very premature delivery and LBWs and vLBW, especially in the singleton septum subgroup.

Conclusion(s)

The hysteroscopic correction of intrauterine septa may not eliminate all risks for premature delivery.
Literatur
2.
Zurück zum Zitat Homer HA, Tin-Chiu Li T-C, Cooke ID. The septate uterus: a review of management and reproductive outcome. Fertil Steril. 2000;73:1–14.CrossRefPubMed Homer HA, Tin-Chiu Li T-C, Cooke ID. The septate uterus: a review of management and reproductive outcome. Fertil Steril. 2000;73:1–14.CrossRefPubMed
3.
Zurück zum Zitat Fatemi HM, Kasius JC, Timmermans A, van Disseldorp J, Fauser BC, Devroey P, et al. Prevalence of unsuspected uterine cavity abnormalities diagnosed by office hysteroscopy prior to in vitro fertilization. Hum Reprod. 2010;25:1959–65.CrossRefPubMed Fatemi HM, Kasius JC, Timmermans A, van Disseldorp J, Fauser BC, Devroey P, et al. Prevalence of unsuspected uterine cavity abnormalities diagnosed by office hysteroscopy prior to in vitro fertilization. Hum Reprod. 2010;25:1959–65.CrossRefPubMed
4.
Zurück zum Zitat Bosteels J, Kasius J, Weyers S, Broekmans FJ, Mol BWJ, D’Hooghe TM. Hysteroscopy for treating subfertility associated with suspected major uterine cavity abnormalities. Cochrane Database of Syst Rev. 2013; 1:Art. No.: CD009461. Bosteels J, Kasius J, Weyers S, Broekmans FJ, Mol BWJ, D’Hooghe TM. Hysteroscopy for treating subfertility associated with suspected major uterine cavity abnormalities. Cochrane Database of Syst Rev. 2013; 1:Art. No.: CD009461.
5.
Zurück zum Zitat Sparac V, Kupesic S, Ilijas M, Zodan T, Kurjak A. Histologic architecture and vascularization of hysteroscopically excised intrauterine septa. J Am Assoc Gynecol Laparosc. 2001;8:111–6.CrossRefPubMed Sparac V, Kupesic S, Ilijas M, Zodan T, Kurjak A. Histologic architecture and vascularization of hysteroscopically excised intrauterine septa. J Am Assoc Gynecol Laparosc. 2001;8:111–6.CrossRefPubMed
6.
Zurück zum Zitat Ozgur K, Isikoglu M, Donme L, Oehninger S. Is hysteroscopic correction of a partial uterine septum justified prior to IVF? Reprod BioMed Online. 2007;14:335–40.CrossRefPubMed Ozgur K, Isikoglu M, Donme L, Oehninger S. Is hysteroscopic correction of a partial uterine septum justified prior to IVF? Reprod BioMed Online. 2007;14:335–40.CrossRefPubMed
7.
Zurück zum Zitat Tomazevic T, Ban-Frangez H, Ribic-Pucelj M, Premru-Srsen T, Verdenik I. Small uterine septum is an important risk variable for preterm birth. Eur J Obstet Gynecol Reprod Biol. 2007;135:154–7.CrossRefPubMed Tomazevic T, Ban-Frangez H, Ribic-Pucelj M, Premru-Srsen T, Verdenik I. Small uterine septum is an important risk variable for preterm birth. Eur J Obstet Gynecol Reprod Biol. 2007;135:154–7.CrossRefPubMed
8.
Zurück zum Zitat Mollo A, de Franciscis P, Colacurci N, Cobellis L, Perino A, Venezia R, et al. Hysteroscopic resection of the septum improves the pregnancy rate of women with unexplained infertility: a prospective controlled trial. Fertil Steril. 2009;91:2628–31.CrossRefPubMed Mollo A, de Franciscis P, Colacurci N, Cobellis L, Perino A, Venezia R, et al. Hysteroscopic resection of the septum improves the pregnancy rate of women with unexplained infertility: a prospective controlled trial. Fertil Steril. 2009;91:2628–31.CrossRefPubMed
9.
Zurück zum Zitat Tomazevic T, Ban-Frangez H, Virant-Klun I, Verdenik I, Pozlep B, Vrtacnik-Bokal E. Septate, subseptate and arcuate uterus decrease pregnancy and live birth rates in IVF/ICSI. Reprod BioMed Online. 2010;21:700–5.CrossRefPubMed Tomazevic T, Ban-Frangez H, Virant-Klun I, Verdenik I, Pozlep B, Vrtacnik-Bokal E. Septate, subseptate and arcuate uterus decrease pregnancy and live birth rates in IVF/ICSI. Reprod BioMed Online. 2010;21:700–5.CrossRefPubMed
10.
Zurück zum Zitat Wang J-H, Xu K-H, Jun Lin J, Chen X-Z. Hysteroscopic septum resection of complete septate uterus with cervical duplication, sparing the double cervix in patients with recurrent spontaneous abortions or infertility. Fertil Steril. 2009;91:2643–9.CrossRefPubMed Wang J-H, Xu K-H, Jun Lin J, Chen X-Z. Hysteroscopic septum resection of complete septate uterus with cervical duplication, sparing the double cervix in patients with recurrent spontaneous abortions or infertility. Fertil Steril. 2009;91:2643–9.CrossRefPubMed
11.
Zurück zum Zitat Taşkın EA, Berker B, Özmen B, Sönmezer M, Atabekoğlu C. Comparison of hysterosalpingography and hysteroscopy in the evaluation of the uterine cavity in patients undergoing assisted reproductive techniques. Fertil Steril. 2011;96:349–52.CrossRefPubMed Taşkın EA, Berker B, Özmen B, Sönmezer M, Atabekoğlu C. Comparison of hysterosalpingography and hysteroscopy in the evaluation of the uterine cavity in patients undergoing assisted reproductive techniques. Fertil Steril. 2011;96:349–52.CrossRefPubMed
12.
Zurück zum Zitat Ozgur K, Isikoglu M. Uterine subseptus: quantification is lacking. 19th ESHRE Annual Meeting, Madrid. Hum Reprod. 2005;8 Suppl 1:117. Ozgur K, Isikoglu M. Uterine subseptus: quantification is lacking. 19th ESHRE Annual Meeting, Madrid. Hum Reprod. 2005;8 Suppl 1:117.
13.
Zurück zum Zitat Gubbini G, di Spiezio SA, Nascetti D, Marra E, Spinelli M, Greco E, et al. New outpatient subclassification system for American Fertility Society classes V and VI uterine anomalies. J Minim Invasive Gynecol. 2009;16:554–61.CrossRefPubMed Gubbini G, di Spiezio SA, Nascetti D, Marra E, Spinelli M, Greco E, et al. New outpatient subclassification system for American Fertility Society classes V and VI uterine anomalies. J Minim Invasive Gynecol. 2009;16:554–61.CrossRefPubMed
14.
Zurück zum Zitat Smit JG, Kasius JC, Eijkemans MJC, Veersema S, Fatemi HM, Evert JP, et al. The international agreement study on the diagnosis of the septate uterus at office hysteroscopy in infertile patients. Fertil Steril. 2013;99:2108–13.CrossRefPubMed Smit JG, Kasius JC, Eijkemans MJC, Veersema S, Fatemi HM, Evert JP, et al. The international agreement study on the diagnosis of the septate uterus at office hysteroscopy in infertile patients. Fertil Steril. 2013;99:2108–13.CrossRefPubMed
15.
Zurück zum Zitat Grimbizis GF, Gordts S, Di Spiezio SA, Brucker S, De Angelis C, Gergolet M, et al. The ESHRE/ESGE consensus on the classification of female genital tract congenital anomalies. Hum Reprod. 2013;28:2032–44.CrossRefPubMedCentralPubMed Grimbizis GF, Gordts S, Di Spiezio SA, Brucker S, De Angelis C, Gergolet M, et al. The ESHRE/ESGE consensus on the classification of female genital tract congenital anomalies. Hum Reprod. 2013;28:2032–44.CrossRefPubMedCentralPubMed
16.
Zurück zum Zitat Hourvitz A, Lerner-Geva L, Elizur SE, Baum M, Levron J, David B, et al. Role of embryo quality in predicting early pregnancy loss following assisted reproductive technology. Reprod BioMed Online. 2006;13:504–9.CrossRefPubMed Hourvitz A, Lerner-Geva L, Elizur SE, Baum M, Levron J, David B, et al. Role of embryo quality in predicting early pregnancy loss following assisted reproductive technology. Reprod BioMed Online. 2006;13:504–9.CrossRefPubMed
17.
Zurück zum Zitat Berkkanoglu M, Ozgur K. The optimum time interval of an ICSI/ET cycle with laparoscopic tubal occlusion for hydrosalpinges. Fertil Steril. 2007;88 suppl 1:S332.CrossRef Berkkanoglu M, Ozgur K. The optimum time interval of an ICSI/ET cycle with laparoscopic tubal occlusion for hydrosalpinges. Fertil Steril. 2007;88 suppl 1:S332.CrossRef
18.
Zurück zum Zitat Ferraretti AP, Goossens V, Mouzon J, Bhattacharya S, Castilla JA, Korsak V, et al. The European IVF-monitoring (EIM), and Consortium, for the European Society of Human Reproduction and Embryology (ESHRE) Assisted reproductive technology in Europe, 2008: results generated from European registers by ESHRE. Hum Reprod. 2012;27:2571–84.CrossRefPubMed Ferraretti AP, Goossens V, Mouzon J, Bhattacharya S, Castilla JA, Korsak V, et al. The European IVF-monitoring (EIM), and Consortium, for the European Society of Human Reproduction and Embryology (ESHRE) Assisted reproductive technology in Europe, 2008: results generated from European registers by ESHRE. Hum Reprod. 2012;27:2571–84.CrossRefPubMed
19.
Zurück zum Zitat Pinborg A, Wennerholm UB, Romundstad LB, Loft A, Aittomaki K, Söderström-Anttil V, et al. Why do singletons conceived after assisted reproduction technology have adverse perinatal outcome? Systematic review and meta-analysis. Hum Reprod Update. 2013;19:87–104.CrossRefPubMed Pinborg A, Wennerholm UB, Romundstad LB, Loft A, Aittomaki K, Söderström-Anttil V, et al. Why do singletons conceived after assisted reproduction technology have adverse perinatal outcome? Systematic review and meta-analysis. Hum Reprod Update. 2013;19:87–104.CrossRefPubMed
20.
Zurück zum Zitat Ban-Frangez H, Tomazevic T, Virant-Klun I, Verdenik I, Ribic-Pucelj N, Vrtacnik-Bokal E. The outcome of singleton pregnancies after IVF/ICSI in women before and after hysteroscopic resection of a uterine septum compared to normal controls. Eur J Obstet Gynecol Reprod Biol. 2009;146:184–7.CrossRefPubMed Ban-Frangez H, Tomazevic T, Virant-Klun I, Verdenik I, Ribic-Pucelj N, Vrtacnik-Bokal E. The outcome of singleton pregnancies after IVF/ICSI in women before and after hysteroscopic resection of a uterine septum compared to normal controls. Eur J Obstet Gynecol Reprod Biol. 2009;146:184–7.CrossRefPubMed
21.
Zurück zum Zitat Saravelos SH, Cocksedge KA, Li T-C. The pattern of pregnancy loss in women with congenital uterine anomalies and recurrent miscarriage. Reprod BioMed Online. 2010;20:416–22.CrossRefPubMed Saravelos SH, Cocksedge KA, Li T-C. The pattern of pregnancy loss in women with congenital uterine anomalies and recurrent miscarriage. Reprod BioMed Online. 2010;20:416–22.CrossRefPubMed
22.
Zurück zum Zitat Rush RW, Keirse MJ, Howat P, Baum JD, Anderson AB, Turnbull AC. Contribution of preterm delivery to perinatal mortality. Br Med J. 1976;23:965–8.CrossRef Rush RW, Keirse MJ, Howat P, Baum JD, Anderson AB, Turnbull AC. Contribution of preterm delivery to perinatal mortality. Br Med J. 1976;23:965–8.CrossRef
23.
Zurück zum Zitat Fox NS, Roman AS, Saltzman DH, Klauser CK, Rebarber A. Twin pregnancy in patients with a uterine anomaly. J Matern Fetal Neonatal Med. 2014;27:360–4.CrossRefPubMed Fox NS, Roman AS, Saltzman DH, Klauser CK, Rebarber A. Twin pregnancy in patients with a uterine anomaly. J Matern Fetal Neonatal Med. 2014;27:360–4.CrossRefPubMed
24.
Zurück zum Zitat McCarthy FP, Khashan AS, North RA, Rahma MB, Walker JJ, Baker PN, et al. Pregnancy loss managed by cervical dilatation and curettage increases the risk of spontaneous preterm birth. Hum Reprod. 2013;28:3197–206.CrossRefPubMed McCarthy FP, Khashan AS, North RA, Rahma MB, Walker JJ, Baker PN, et al. Pregnancy loss managed by cervical dilatation and curettage increases the risk of spontaneous preterm birth. Hum Reprod. 2013;28:3197–206.CrossRefPubMed
25.
Zurück zum Zitat Pundir J, Pundir V, Omanwa K, Khalaf Y, El-Toukhy T. Hysteroscopy prior to the first IVF cycle: a systematic review and meta-analysis. Reprod BioMed Online. 2014;28:151–61.CrossRefPubMed Pundir J, Pundir V, Omanwa K, Khalaf Y, El-Toukhy T. Hysteroscopy prior to the first IVF cycle: a systematic review and meta-analysis. Reprod BioMed Online. 2014;28:151–61.CrossRefPubMed
26.
Zurück zum Zitat Jin X-Y, Kuang L, Lin X-N, Huang D, Zhang S-Y. Cervical cerclage before blastocyst transfer in patients having cryopreserved embryo transfer. Fertil Steril. 2009;92:392.e9–.e12.CrossRef Jin X-Y, Kuang L, Lin X-N, Huang D, Zhang S-Y. Cervical cerclage before blastocyst transfer in patients having cryopreserved embryo transfer. Fertil Steril. 2009;92:392.e9–.e12.CrossRef
27.
Zurück zum Zitat Berghella V, Ludmir J, Simonazzi G, Owen J. Transvaginal cervical cerclage: evidence for perioperative management strategies. Am J Obstet Gynecol. 2013;209:181–92.CrossRefPubMed Berghella V, Ludmir J, Simonazzi G, Owen J. Transvaginal cervical cerclage: evidence for perioperative management strategies. Am J Obstet Gynecol. 2013;209:181–92.CrossRefPubMed
28.
Zurück zum Zitat Wahabi HA, Fayed AA, Esmaeil SA, Al Zeidan RA. Progestogen for treating threatened miscarriage. Cochrane Database Syst Rev. 2011;7; CD005943. Wahabi HA, Fayed AA, Esmaeil SA, Al Zeidan RA. Progestogen for treating threatened miscarriage. Cochrane Database Syst Rev. 2011;7; CD005943.
Metadaten
Titel
Perinatal outcomes in singleton and twin ICSI pregnancies following hysteroscopic correction of partial intrauterine septa
verfasst von
Kemal Ozgur
Hasan Bulut
Murat Berkkanoglu
Kevin Coetzee
Publikationsdatum
01.04.2015
Verlag
Springer US
Erschienen in
Journal of Assisted Reproduction and Genetics / Ausgabe 4/2015
Print ISSN: 1058-0468
Elektronische ISSN: 1573-7330
DOI
https://doi.org/10.1007/s10815-015-0444-z

Weitere Artikel der Ausgabe 4/2015

Journal of Assisted Reproduction and Genetics 4/2015 Zur Ausgabe

Hirsutismus bei PCOS: Laser- und Lichttherapien helfen

26.04.2024 Hirsutismus Nachrichten

Laser- und Lichtbehandlungen können bei Frauen mit polyzystischem Ovarialsyndrom (PCOS) den übermäßigen Haarwuchs verringern und das Wohlbefinden verbessern – bei alleiniger Anwendung oder in Kombination mit Medikamenten.

ICI-Therapie in der Schwangerschaft wird gut toleriert

Müssen sich Schwangere einer Krebstherapie unterziehen, rufen Immuncheckpointinhibitoren offenbar nicht mehr unerwünschte Wirkungen hervor als andere Mittel gegen Krebs.

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

Bislang gibt es kein Medikament zur Prävention von Wochenbettdepressionen. Das Injektionsanästhetikum Esketamin könnte womöglich diese Lücke füllen.

Bei RSV-Impfung vor 60. Lebensjahr über Off-Label-Gebrauch aufklären!

22.04.2024 DGIM 2024 Kongressbericht

Durch die Häufung nach der COVID-19-Pandemie sind Infektionen mit dem Respiratorischen Synzytial-Virus (RSV) in den Fokus gerückt. Fachgesellschaften empfehlen eine Impfung inzwischen nicht nur für Säuglinge und Kleinkinder.

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.