弓形子宮對胚胎植入後著床率無明顯不良影響

Fertil Steril. 2018 Mar 30. pii: S0015-0282(17)32117-9. doi: 10.1016/j.fertnstert.2017.12.001. [Epub ahead of print]

The arcuate uterus: is there an impact on in vitro fertilization outcomes after euploid embryo transfer?

Surrey ES1, Katz-Jaffe M2, Surrey RL3, Small AS2, Gustofson RL2, Schoolcraft WB2.

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Abstract

OBJECTIVE:

To study the impact of the arcuate uterus on euploid blastocyst-stage embryo transfer outcomes after comprehensive chromosomal screening (CCS).

DESIGN:

Controlled retrospective trial.

SETTING:

Tertiary care assisted reproduction technology (ART) center.

PATIENT(S):

Consecutive patients undergoing in vitro fertilization and euploid embryo transfer after CCS during 2014.

INTERVENTION(S):

Ultrasound examinations and office hysteroscopy; array comparative genomic hybridization to perform CCS after a trophectoderm biopsy.

MAIN OUTCOME MEASURE(S):

Implantation and live-birth rates.

RESULT(S):

Patients were divided into two groups based on the presence (group 1) or absence (group 2) of arcuate uterus. Exclusion criteria were donor oocytes, evidence of other endometrial cavitary abnormalities, prior uterine surgery, and arcuate uterus <4 mm. Group 1 included 78 patients with arcuate uterus of mean depth 5.43 ± 1.81 mm (range: 4-9.5 mm) undergoing 83 transfer cycles. Group 2 included 354 controls undergoing 378 transfer cycles. There were no differences between the groups in baseline characteristics or mean number of euploid embryos transferred. Cycle outcomes were similar between the two groups: rates of implantation (63.7% vs. 65.4%), live birth (68.67% vs. 67.81%), biochemical pregnancy (8.4% vs. 7.65%), and spontaneous abortion (4.8% vs. 4.27%).

CONCLUSION(S):

Arcuate uterus has no impact on ART outcomes after euploid embryo transfer subsequent to CCS, so arcuate uterus should be considered an incidental finding without an indication for surgical resection.