The obstetric outcome of in vitro fertilization and embryo transfer in women with congenital uterine malformation

Abstract

OBJECTIVE: Our purpose was to analyze 3 obstetric outcomes according to the various forms of congenital uterine malformation after in vitro fertilization and embryo transfer. STUDY DESIGN: We conducted a retrospective analysis of data from 24 patients with the following types of congenital uterine malformation: 6 unicornuate, 9 bicornuate, 5 septate, and 4 uterus didelphys. All patients underwent in vitro fertilization and embryo transfer at Bourn Hall Clinic, a tertiary infertility referral center. RESULTS: Twenty-four patients conceived a total of 19 clinical pregnancies in 51 embryo transfer cycles. The clinical pregnancy rate was 19 of 51 (37.3%) per embryo transfer and 17 of 24 (70.8%) per patient. There were no significant differences in the clinical pregnancy rates when the various forms of uterine malformation were compared. There was a trend for the group with unicornuate uteri and uterus didelphys to have the highest rate of term delivery (6/9, 66.7%) and the lowest rate of first-trimester miscarriages (0/9, 0%) as compared with the group with septate and bicornuate uteri, in whom the term delivery rate was 1 of 10 (10%) and the spontaneous abortion rate was 3 of 10 (30%). The multiple pregnancy rate was 6 of 15 (40%) for women who had three embryos transferred, as compared with 0 in women who had two embryos or one embryo transferred. There was a high rate of preterm delivery (6/13, 46.2%) and cesarean section (10/13, 76.9%). CONCLUSION: In vitro fertilization and embryo transfer in women with congenital uterine malformation is associated with good pregnancy rates, and the patients should be counseled about the risks involved, in particular, the increased rate of preterm delivery and cesarean section. (Am J Obstet Gynecol 1996;175:85-9.)