Effect of previous wedge resection for interstitial pregnancy on pregnancy and neonatal outcomes following frozen-thawed embryo transfer (FET) cycles of IVF/ICSI: a retrospective study

Reprod Biol Endocrinol. 2022 Feb 1;20(1):23. doi: 10.1186/s12958-022-00896-4.

Abstract

Objective: The present study aimed to evaluate pregnancy and neonatal outcomes in women, with a previous history of wedge resection for interstitial pregnancy, in frozen-thawed embryo transfer (FET) cycles of IVF/ICSI.

Methods: The present study involved a retrospective case-control assessment of 75 cases and 375 control subjects over 6 years in a single center. To compare pregnancy and neonatal outcomes between cases, treated using wedge resection, and controls without any previous history of ectopic pregnancy, propensity score matching (1:5) was utilized. The study also compared subgroups in the case group.

Results: Women with previous wedge resection exhibited higher rates of ectopic pregnancy and uterine rupture rate as compared to control subjects (9.1% vs 1.3%, P = 0.025 and 4.5% vs 0%, P = 0.035, respectively). No statistically significant differences were recorded between the two cohorts with regard to clinical pregnancy rate, live birth rate, and neonatal outcomes. For pregnancy type subgroup analysis, Z-score and rates of large for gestational age were recorded to be significantly lower in twin pregnancy subgroup when compared with singleton pregnancy subgroup (0.10 (- 0.59, 0.25) vs 0.50 (- 0.97, 1.39), P = 0.005; 4.5% vs 26.1%, P = 0.047, respectively).

Conclusion: The results of the present study indicated that previous wedge resection correlated to a higher risk of ectopic pregnancy and uterine rupture. However, it might not be related to an increased risk of adverse neonatal outcomes. The study recommended cesarean section in these patients. Further studies are required to verify the validity of current recommendations.

Keywords: Frozen embryo transfer; Interstitial pregnancy; Neonatal outcomes; Pregnancy outcomes; Wedge resection.

MeSH terms

  • Adult
  • Birth Rate
  • Case-Control Studies
  • China / epidemiology
  • Embryo Transfer* / methods
  • Embryo Transfer* / statistics & numerical data
  • Female
  • Fertilization in Vitro / statistics & numerical data
  • Humans
  • Infant, Newborn
  • Infertility / epidemiology
  • Infertility / therapy
  • Male
  • Obstetric Surgical Procedures / methods
  • Obstetric Surgical Procedures / rehabilitation
  • Obstetric Surgical Procedures / statistics & numerical data
  • Pregnancy
  • Pregnancy Outcome* / epidemiology
  • Pregnancy Rate
  • Pregnancy, Interstitial / epidemiology
  • Pregnancy, Interstitial / rehabilitation*
  • Pregnancy, Interstitial / surgery
  • Retrospective Studies
  • Sperm Injections, Intracytoplasmic* / statistics & numerical data