| Background:mullerian ducts anomalies(MDA)are congenital malformation of the female reproductive tract in obstetrics and gynecology,in which the bicornuate uterus is caused by the fusion disorder of paramesonephric duct(also called muller duct)in the period of embryo.The incidence rates of this malformation are not low in population,and it is more common in the infertility woman.The literature of bicornuate uterus are mostly about case reports,imaging examination and birth outcome after natural conception,if this part of the patients are diagnosed with infertility,they can be conceived with the help of assisted reproductive technology(ART).Researches about ART outcome both based on the small number of cases studies,there is no large number of cases cohort study.Purpose:the purpose of this study was to evaluate the effects of IVF/ICSI treatment in patients with infertility(as defined by the American Fertility Society),including pregnancy outcomes and obstetric outcomes,and to provide clinical treatment guidance for patients with bicornuate uterus.Method:We take 58 patients with bicornuate uterus and accepted IVF/ICSI treatment in our center through 2009-2018 into the research group,then select the age,body mass index(BMI),and whether with polycystic ovary syndrome(PCOS)as the essential conditions,the stimulation in controlled ovarian hyperstimulation(COH)cycle,the number of embryo transplanted and other indicators as the optional conditions,to match 174 normal uterus patients as control group,conducting a retrospective cohort study.The basic characteristics,COH status and pregnancy follow-up records of these patients were collected,and the differences in enbryo implantation rate,clinical pregnancy rate,abortion rate,and neonatal birth weight were compared between the two groups.The cumulative live birth rate was taken as the main indicator.Results:The baseline data of patients with bicornuate uterus were comparable to those of the control group,and there was no difference between the two groups in the indicator of controlled ovarian hyperstimulation,including the number of oocytes collected,and the number of high-quality embryos.In fresh cycle of embryo transplantation,infertility patients with bicornuate uterine-s embryo implantation rate(32.7%vs 42.9%,P=0.176),biochemical pregnancy rate(54.1%vs 64.9%,P=0.236),and clinical pregnancy rate(45.9%vs 58.8%,P=0.172)are relatively lower than the normal shape of uterus,multiple pregnancy rate also no statistical difference between the two groups(5.9%vs 17.9%,P=0.221).After fresh embryo transplantation,2 patients with bicornuate uterus had early abortion,no ectopic pregnancy and late abortion,and there was no significant difference between them and those with normal uterus.Statistical analysis of obstetric outcomes of fresh embryo transplantation patients revealed that the live birth rate(40.5%vs 43.9%,P=0.723),full-term birth rate(93.3%vs 90.0%,P=0.696),cesarean section rate(73.3%vs 76.0%,P=0.833)and newborn birth weight(3.35±0.56 vs 3.32±0.51,P=0.524)were not significantly different from the control group.Similar results were obtained by transplanting embryos during the freeze-thaw cycle.At the end of one IVF/ICSI cycle,the cumulative live birth rate(58.2%vs 64.8%,P=0.375)and cumulative pregnancy rate(59.6%vs 71.0%,P=0.112)in patients with bicornuate uterus is similar to these of the normal uterus.There was no significant difference in the incidence of obstetric complications including premature rupture of membranes and placenta previa and so on.Conclusion:There was no statistical difference in ovarian response,pregnancy outcome and obstetric outcome after IVF/ICSI treatment between the bicornuate uterus and those with normal uterus,and there was no significantly negative effects bicornuate uterus have on ART outcome of infertile patients. |
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