What is the best time to perform intracytoplasmic sperm injection/embryo transfer cycle after hysteroscopic surgery for an incomplete uterine septum?

OBJECTIVE

To determine whether there is an optimal time period to perform intracytoplasmic sperm injection (ICSI)/embryo transfer cycle after hysteroscopic resection of an incomplete uterine septum.

DESIGN

A retrospective cohort study.

SETTING

Private infertility clinic.

PATIENT(S): A total of 282 women, who had undergone an ICSI/embryo transfer cycle after hysteroscopic resection of an incomplete uterine septum (from May 6, 2003 to January 1, 2006).

INTERVENTION(S): One hundred thirty-three patients (group A) underwent an ICSI/embryo transfer cycle within 9 weeks after hysteroscopic resection of an incomplete uterine septum, 93 patients (group B) underwent an ICSI/embryo transfer cycle between 10 and 16 weeks after hysteroscopic resection of an incomplete uterine septum, and 56 patients (group C) underwent an ICSI/embryo transfer cycle more than 17 weeks after hysteroscopic resection of an incomplete uterine septum.

MAIN OUTCOME MEASURE(S): Peak E(2) levels, total recombinant FSH dosage, MII oocytes retrieved, number of embryos transferred, number of grade 1 embryo transferred, pregnancy rate (PR; positive hCG), clinical PR (positive fetal cardiac activity), implantation rate, and first trimester miscarriage rate.

RESULT(S): Pregnancy rates were 52.6%, 52.6%, and 46.4% for groups A, B, and C, respectively. Clinical PRs were 45.8%, 43.1%, and 41.1% for groups A, B, and C, respectively. Implantation rates were 21.1%, 17.6%, and 22.1% for groups A, B, and C, respectively. First trimester miscarriage rates were 6.4%, 7.9%, and 5.1% for groups A, B, and C, respectively. There were no significant differences in the etiology of infertility, age, length of infertility, previous spontaneous abortion rates, length of septum, peak serum E(2) concentration, total recombinant FSH dosage, total number of MII oocytes retrieved, number of embryos transferred, number of grade 1 embryos transferred, PRs, clinical PRs, implantation rates, and first trimester miscarriage rate between the three groups.

CONCLUSION(S): Starting an ICSI/embryo transfer cycle just after the hysteroscopic procedure does not result in any impairment in implantation rate or PR compared to those started 10 or more weeks after the operation.