Study Objective: To study the impact of Müllerian anomalies on reproductive outcomes in a recurrent pregnancy loss (RPL) population and to evaluate the effect of surgical correction of uterine septum on the odds of achieving live birth in RPL patients with a septate uterus.
Design: A retrospective cohort study.
Setting: A specialized RPL clinic at a tertiary center.
Patients: RPL patients with ≥ 2 pregnancy losses before 20 weeks' gestation who attended a specialized RPL clinic.
Intervention: We aimed to assess the association between a possible risk factor (Müllerian anomalies) and reproductive outcomes and that between having surgery for septate uterus and achieving a live birth.
Measurements And Main Results: The primary outcome is live birth rate in RPL patients with Müllerian anomalies compared with those without; secondary outcome measures include rates of full-term live birth, preterm live birth, first and second trimester pregnancy loss, and stillbirth. After adjusting for patient age at the initial RPL visit, the number of pregnancy losses, and the presence of any other abnormal RPL investigation, the odds of achieving live birth were on average 49.4% lower for patients with a septate uterus than those without Müllerian anomalies (odds ratio, 0.51; 95% confidence interval, 0.30-0.86) in the studied cohort (n = 377). A subanalysis of 72 patients with septate uterus demonstrated a higher likelihood of live birth in those who underwent septum resection (46/72; 63.9%) than those who elected to go for expectant management (26/72; 36.1%), yet this study was underpowered to establish a significant difference (52.2% vs 34.6%; p = .22).
Conclusion: In RPL patients, having a septate uterus significantly decreased the chances of achieving live birth. Patients with septate uterus who received hysteroscopic septum division had a higher tendency to achieve more live births than those who elected expectant management. However, our study was underpowered to detect a statistically significant difference.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jmig.2023.07.012 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Antioxidant therapy for infertile couples: a comprehensive review of the current status and consideration of future prospects.
Front Endocrinol (Lausanne)
January 2025
Department of Obstetrics and Gynaecology, Assiut University, Assiut, Egypt.
Oxidative stress (OS) is established as a key factor in the etiology of both male and female infertility, arising from an imbalance between reactive oxygen species (ROS) production and the endogenous antioxidant (AOX) defenses. In men, OS adversely affects sperm function by inducing DNA damage, reducing motility, significantly impairing sperm vitality through plasma membrane peroxidation and loss of membrane integrity, and ultimately compromising overall sperm quality. In women, OS is implicated in various reproductive disorders, including polycystic ovary syndrome, endometriosis, and premature ovarian failure, leading to diminished oocyte quality, disrupted folliculogenesis, and poorer reproductive outcomes.
View Article and Find Full Text PDFCost-effectiveness Analysis of Uterus Transplantation versus Gestational Carrier for Treatment of Absolute Uterine Factor Infertility.
Fertil Steril
January 2025
The Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA; Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA.
Importance: Patients with uterine factor infertility (UFI) have few options for family building. Uterus transplant is a feasible treatment for some patients; however, cost remains a significant concern.
Objective: To compare the cost effectiveness of treatment for patients with absolute uterine factor infertility to achieve 1-2 singleton births by gestational carrier or uterus transplant DESIGN: Decision analysis from the United States healthcare sector perspective, with time horizons to achieve one or two singleton births.
Objective: To compare pregnancy outcomes and serum progesterone levels between women who took sublingual (SL) progesterone lozenges versus intramuscular (IM) progesterone-in-oil for endometrial preparation and luteal support in programmed frozen embryo transfer (pFET) cycles.
Design: Retrospective cohort study.
Subjects: All patients who underwent pFET of a single euploid good-quality blastocyst between January 2018 and April 2023 at a single fertility center.
Comparing gestational carrier to uterine transplantation in uterine-factor infertility: a cost-effectiveness analysis.
Fertil Steril
January 2025
Shady Grove Fertility, Rockville, MD, USA.
Objective: To compare the cost-effectiveness of a gestational carrier to a uterine transplantation in the treatment of absolute uterine-factor infertility.
Design: We performed a cost-effectiveness analysis using a decision-tree mathematical model comparing a gestational carrier to a uterine transplantation.
Subjects: Published literature was used to derive costs for solid organ transplant, immunosuppression, gestational carrier obtainment, in vitro fertilization, preimplantation genetic testing, and frozen embryo transfer.
All-Cause and Cause-Specific Mortality in Children With Congenital Zika Syndrome in Brazil.
JAMA Netw Open
January 2025
Center of Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil.
Importance: Congenital Zika syndrome (CZS) can lead to a range of developmental and neurological issues, which increases the risk of early death. However, the all-cause and cause-specific mortality in children with CZS in the first 5 years of life remain unknown.
Objective: To compare the hazard of all-cause and cause-specific mortality before age 5 years among children with and without CZS in Brazil.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!