Reduced pregnancy and live birth rates after in vitro fertilization in women with cesarean section scar diverticulum: A retrospective cohort study

Aim The primary aim of the study was to investigate the effect of cesarean scar diverticulum on the reproductive outcome of embryo transfer. The secondary aim was to assess the impact of endometrial cavity fluid on the reproductive outcome of embryo transfer among patients with a cesarean scar diverticulum. Methods This was a retrospective cohort study. The study included 1538 patients, of whom 215 patients with an existing cesarean scar diverticulum and 1323 patients without cesarean scar diverticulum. A subgroup analysis of the impact of endometrial cavity fluid on the reproductive outcome of frozen embryo transfers among patients with a cesarean scar diverticulum was also conducted. Results The odds of clinical pregnancy in the noncesarean section diverticulum group was higher than that in the diverticulum group (odds ratio [OR]: 1.72, 95% confidence interval [CI]: 1.27-2.34 and adjusted OR: 1.71, 95% CI: 1.25-2.34). The odds of live birth in the noncesarean section diverticulum group was also significantly higher than that in the cesarean section diverticulum group (OR: 1.61, 95% CI: 1.15-2.24 and adjusted OR: 1.59, 95% CI: 1.14-2.23). The existence of endometrial cavity fluid during endometrial preparation significantly reduced the pregnancy and live birth rate of frozen embryo transfer among the patients with cesarean section diverticulum. Conclusion The presence of cesarean section scar diverticulum had an adverse impact on the pregnancy and live birth rate after in vitro fertilization. The endometrial cavity fluid among the patients with cesarean section scar diverticulum accounted for the reduced pregnancy and live birth rate partly.