OBSTETRIC OUTCOME OF IN-VITRO FERTILIZATION AND EMBRYO-TRANSFER IN WOMEN WITH CONGENITAL UTERINE MALFORMATION

OBJECTIVE: Our purpose was to analyze 3 obstetric outcomes according t o the various forms of congenital uterine malformation after in vitro fertilization and embryo transfer. STUDY DESIGN: We conducted a retros pective analysis of data from 24 patients with the following types of congenital uterine malformation: 6 unicornuate, 9 bicornuate, 5 septat e, and 4 uterus didelphys. All patients underwent in vitro fertilizati on and embryo transfer at Bourn Hall Clinic, a tertiary infertility re ferral center. RESULTS: Twenty-four patients conceived a total of 19 c linical pregnancies in 51 embryo transfer cycles. The clinical pregnan cy 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 pre gnancy rates when the various forms of uterine malformation were compa red. 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 del ivery rate was 1 of 10 (10%) and the spontaneous abortion rate was 3 o f 10 (30%). The multiple pregnancy rate was 6 of 15 (40%) for women wh o had three embryos transferred, as compared with 0 in women who had t wo embryos or one embryo transferred. There was a high rate of preterm delivery (6/13, 46.2%) and cesarean section (10/13, 76.9%). CONCLUSIO N: 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.