Uyar Esra, Usal Deniz, Selam Belgin, Cincik Mehmet, Bagis Tayfun
Acibadem Altunizade Hospital, Unit of ART, Istanbul, Turkey.
Department of Obstetrics and Gynecology, Acibadem Mehmet Ali Aydinlar University, School of Medicine; Acibadem Altunizade Hospital, Unit of ART, Altunizade Mah. Tophanelioğlu Cad. Okul Sokak, No:1, Üsküdar, 34662 İstanbul, Turkey.
Fertil Res Pract. 2019 Dec 4;5:15. doi: 10.1186/s40738-019-0063-y. eCollection 2019.
T- shaped uterus may be associated with infertility and adverse pregnancy outcomes. Hysteroscopic metroplasty may improve the reproductivity for these cases. To our knowledge, there is no data in literature about the clinical consequences of in vitro fertilization (IVF) in patients undergoing hysteroscopic metroplasty for T-shaped uterus. The principal objective of the current study is to assess the impact of hysteroscopic metroplasty for T-shaped uterus on the reproductive outcomes of IVF.
IVF outcomes of 74 patients who underwent hysteroscopic metroplasty for T- shaped uterus and 148 patients without any uterine abnormalities and with diagnosis of unexplained infertility (control group) were retrospectively analyzed.
Patients in metroplasty and control groups were comparable with respect to age, BMI, partner's age and duration of infertility. Number of patients with a history of pregnancy beyond 20 weeks of gestation was significantly lower in the metroplasty group (4.1% vs 18.2%; < 0.05). Number of previous unsuccessful cycles and percentage of patients with ≥3 unsuccessful IVF cycles (35.1% vs 17.6%; < 0.05) were significantly higher in the metroplasty group. There were no significant differences in the reproductive outcomes such as the pregnancy rate, clinical pregnancy or live birth rate between the metroplasty and control groups. There were non-significant trends for higher rates of miscarriage (18.8% vs 8%, > 0.05) and biochemical pregnancy (20.0% vs 10.7%, > 0.05) in the metroplasty group compared to the control group.
Reproductive results of the IVF cycles after hysteroscopic correction of T-shaped uterus were comparable to those of the patients without any uterine abnormalities and with diagnosis of unexplained infertility. Hysteroscopic metroplasty may contribute to improved IVF outcomes in patients with T-shaped uterus.
T形子宫可能与不孕及不良妊娠结局相关。宫腔镜子宫成形术可能改善这些病例的生殖能力。据我们所知，文献中尚无关于接受T形子宫宫腔镜子宫成形术患者体外受精（IVF）临床后果的数据。本研究的主要目的是评估T形子宫宫腔镜子宫成形术对IVF生殖结局的影响。
回顾性分析74例接受T形子宫宫腔镜子宫成形术的患者及148例无子宫异常且诊断为不明原因不孕患者（对照组）的IVF结局。
子宫成形术组和对照组在年龄、体重指数、配偶年龄及不孕持续时间方面具有可比性。子宫成形术组妊娠超过20周的患者数量显著低于对照组（4.1%对18.2%；P<0.05）。子宫成形术组既往未成功周期数及IVF周期≥3次未成功的患者百分比显著高于对照组（35.1%对17.6%；P<0.05）。子宫成形术组与对照组在妊娠率、临床妊娠率或活产率等生殖结局方面无显著差异。与对照组相比，子宫成形术组流产率（18.8%对8%，P>0.05）和生化妊娠率（20.0%对10.7%，P>0.05）有升高趋势，但差异无统计学意义。
T形子宫宫腔镜矫正术后IVF周期的生殖结果与无子宫异常且诊断为不明原因不孕患者的结果相当。宫腔镜子宫成形术可能有助于改善T形子宫患者的IVF结局。
