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The association between operative hysteroscopy prior to assisted reproductive technology and cervical insufficiency in second trimester

  • Gynecologic Endocrinology and Reproductive Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To assess the association between operative hysteroscopy prior to assisted reproductive technology (ART) cycle and cervical insufficiency (CI) in the second trimester of pregnancy.

Methods

A retrospective cohort study was conducted. The charts of all women who got pregnant following an ART cycle between January 2015 and June 2018 were reviewed. The study group consisted of pregnant women who underwent operative hysteroscopy within 6 months before conception. The control group consisted of pregnant women who did not undergo hysteroscopy or any type of cervical surgical procedure before conception. The primary outcome measure was CI during the second trimester (13–27 weeks of gestation).

Results

A total of 363 pregnancies achieved by ART cycles were assessed. After the exclusion of multiple pregnancies (n = 19), previous surgical procedures (n = 4) and first-trimester pregnancy losses (n = 80), there were 29 women in the study group and 231 women in the control group. The mean ages of the study and control groups were 31.2 ± 4.06 and 29.82 ± 4.71 years, respectively (P = 0.13). The indications for operative hysteroscopy were uterine septum (n = 19), T-shaped uterus (n = 4), endometrial polyp (n = 4), and submucosal fibroids (n = 2). The rates of CI in the study and control groups were 13.7% (4/29) and 3.4% (8/231), respectively (P = 0.012). The term delivery rates in the study and control groups were 79.3 and 91.8%, respectively (P = 0.044).

Conclusions

Operative hysteroscopy prior to ART cycles is significantly associated with CI between 13 and 27 weeks of gestation. Further investigation with larger cohorts is urgently needed to clarify this issue.

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This is a retrospective analysis of our hospital records, and we cannot share data without informing the patients about we will share their medical records.

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Funding

The authors received no specific funding for this work.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Cebeci Hospital, Ankara University School of Medicine, Dikimevi, 06100, Ankara, Turkey

    Ali Gökçe, Yavuz Emre Şükür, Batuhan Özmen, Murat Sönmezer, Bülent Berker, Ruşen Aytaç & Cem Somer Atabekoğlu

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  1. Ali Gökçe
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  2. Yavuz Emre Şükür
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  3. Batuhan Özmen
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  4. Murat Sönmezer
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  5. Bülent Berker
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  6. Ruşen Aytaç
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  7. Cem Somer Atabekoğlu
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Contributions

AG: data collection or management, manuscript writing/editing, and data analysis. YEŞ: data collection or management, manuscript writing/editing, and data analysis. BÖ: data collection or management and manuscript writing/editing. MS: data collection or management and manuscript writing/editing. BB: data collection or management and manuscript writing/editing. RA: data collection or management and manuscript writing/editing. CSA: protocol/project development and manuscript writing/editing.

Corresponding author

Correspondence to Ali Gökçe.

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Conflict of interest

The authors of this article report no financial or non-financial conflict of interest.

Ethical approval

The study was approved by the Institutional Review Board of Ankara University (Approval no. and date: 8484 and 02.12.2020).

Consent to participate

In our country, IRB does not require consent to participate form for retrospective analyses, they just need of chief physician’s permission.

Consent for publication

All the authors declare that they participated in the study and development in manuscript titled “The association between operative hysteroscopy prior to assisted reproductive technology and cervical insufficiency in second trimester”. In addition, they give their consent for the article published in Archives of Gynecology and Obstetrics.

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Gökçe, A., Şükür, Y.E., Özmen, B. et al. The association between operative hysteroscopy prior to assisted reproductive technology and cervical insufficiency in second trimester. Arch Gynecol Obstet 303, 1347–1352 (2021). https://doi.org/10.1007/s00404-020-05863-1

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  • DOI: https://doi.org/10.1007/s00404-020-05863-1

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