In patients with isthmocele undergoing IVF, the risk of ectopic pregnancy on the cesarean scar is reduced only if the ultrasound-guided transfer is performed on day 5-A retrospective case-control study

OBJECTIVE: The study aimed to demonstrate that the risk of Cesarean Scar Pregnancy (CSP) for patients with isthmocele decreases when the embryo transfer is per-formed on day 5 at the blastocyst stage. PATIENTS AND METHODS: From January 2014 to December 2021, 167 patients who previously had an IVF treatment and delivered by cesarean section, were selected. The isthmocele was found in 98 of them. Firstly, we evaluated whether the isthmocele increases the risk of CSP. Subsequently, we investigated the possible correlation between the risk of the CSP with the day of the embryo transfer. Hence, the selected patients were divided into two groups: Group A where the embryo transfer was per-formed at the cleavage stage on day 3 and Group B where the embryo was transferred at the blastocyst stage on day 5. RESULTS: The outcomes show that the isthmocele does not seem to increase the risk of CSP, while the embryo transfer on day 3 increas-es its rate. CONCLUSIONS: When the isthmocele is diagnosed, according to our results, an embryo transfer on day 5 at the blastocyst stage seems to minimize the risk of the CSP.