Effect of aspiration with policresulen coagulation of isthmocele on ivf outcome in infertile patients undergoing ivf treatment.

This study was performed to investigate the effect of aspiration with policresulen coagulation (APOC) of the large isthmocele after previous cesarean section delivery on IVF outcome in infertile women undergoing IVF-ET treatment. A total of 87 consecutive IVF-ET cycles in 87 infertile patients with large isthmocele with residual myometrial thickness (RMT) less than 3mm who underwent IVF-ET between May 2018 and March 2021 was included in this retrospective cohort study. In 45 patients of 87, APOC was performed immediately after oocyte pick-up (OPU) in IVF-ET cycles. Forty-two patients who did not receive APOC were served as controls. In all subjects, GnRH antagonist protocol was used for COS. IVF results and pregnancy outcome were compared between the APOC and control groups. Mean values were expressed as mean±standard deviation (SD). Student’s t-test was used to compare mean values. Chi-square test and Fisher’s exact test were used to compare fraction. Statistical significance was defined as P<0.05. All analyses were performed by using SPSS statistical package for Windows, version 11.0 (SPSS Inc, Chicago, IL). The demographic characteristics of subjects were comparable between the APOC and control groups. Incidence of intracavitary fluid (ICF) on the day of OPU was also similar in the two groups. There were no differences in the two groups with respect to total dose and days of gonadotropins used for COS, and the numbers of oocytes retrieved, mature oocytes retrieved, fertilized oocytes and grade 1 or 2 embryos. Clinical pregnancy rate (CPR) seemed to be higher in the study, but the difference did not achieve the statistical significance (P = .077). However, embryo implantation rate was significantly higher in the APOC group of 28.4% (23/81) compared with 15.0% (12/80) in the control group (P = .040). Miscarriage rate was similar in the two groups. APOC treatment performed immediately after OPU is an effective and safe procedure to increase embryo implantation rates in infertile patients with large isthmocele undergoing IVF-ET.