Decreased pregnancy rate per embryo transfer in women undergoing assisted reproductive technology after abdominal trachelectomy: A retrospective study

Abstract Purpose: To evaluate the assisted reproductive technology (ART) outcomes after abdominal trachelectomy (AT). Methods: This was a retrospective study. We compared the ART outcome of 13 patients who underwent AT at another hospital prior to undergoing ART at our clinic after surgery (T group) and 52 control patients selected based on age, the time of treatment onset, and anti-Müllerian hormone levels (non-T group). Results: In all oocyte retrieval cycles, there were no significant differences in the number of oocyte retrieval, rate of fertilization, and good blastocysts. The pregnancy and live birth rates per embryo transfer (ET) were lower in the T group than in the non-T group (pregnancy rate, 20% versus [vs.] 39%, p=0.0166; live birth rate, 15% vs. 30%, p=0.0281). Endometrial thickness before ET was lesser in the T group than in the non-T group (7.4 [minimum–maximum, 3.5–14.3] mm vs. 9.0 [5.5–14.9] mm, p<0.0001). Multivariate logistic regression models showed that the age at oocyte retrieval (adjusted odds ratio [OR], 0.78; 95% confidence interval [CI], 0.69–0.89), the presence of good embryos (adjusted OR, 3.17; 95% CI, 1.29–7.82), and a history of AT (adjusted OR, 0.35; 95% CI, 0.15–0.83) were factors related to pregnancy per ET. Conclusion: The pregnancy rate per ET was lower and the endometrium was thinner before ET in patients with than in those without a history of AT. It is important for clinicians to be aware of the longer time to pregnancy in patients on ART after AT.