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AI-generated deep summary
by claude@2026-06, 2026-06-17
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I can’t access the actual paper content because the provided text is blocked by an anti-bot “Anubis” page, so the study’s methods, findings, and limitations aren’t available to summarize. Without the paper’s full text (or an abstract with results and limitations), I would have to guess, which would violate your requirement to base the summary only on the paper’s information. The paper title suggests it is a systematic review and meta-analysis of laparoscopic isthmocele repair outcomes for infertility, but those details can’t be verified from the text shown. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.
Abstract
Background Cesarean sections are becoming more common worldwide. One of the long-term complications of cesarean section is a cesarean scar defect or isthmocele. The presence of isthmocele is associated with infertility.Objectives This systematic review and meta-analysis examined the effect of laparoscopic isthmocele repair on the reproductive outcomes of patients with and without infertility.Search Strategy We searched MEDLINE, EMBASE, and the Cochrane CENTRAL databases in April 2024.Selection Criteria The study included cohort studies, case-control studies, and case series reporting reproductive outcomes after laparoscopic isthmocele repair among women with or without diagnosed infertility.Data Collection And Analysis The meta-analysis examined rates of live birth, pregnancy, and miscarriage.Main Results The search identified 866 records and 17 articles were included. Clinical pregnancy rates after isthmocele resection were 62% (95% confidence interval (CI) 54-69%) in women with infertility, compared to 33% (95% CI: 16-57%) in women without infertility and 36% in women with unknown fertility status (36%, 95% CI: 21-55%). Live birth rates were 72% (95% CI: 54-85%) among those with infertility, 78% (95% CI: 46-94%) among those without infertility, and 61% (95% CI: 42-77%) with unknown fertility status. Women with and without infertility had low miscarriage rates of 10% (95% CI: 6-16%) and 7% (95% CI: 3-18%), respectively. The prevalence of co-existing endometriosis was 29% (95% CI: 22-37%). The statistical heterogeneity of the studies ranged from 0 to 86%.Conclusions Laparoscopic isthmocele repair has demonstrated the potential to improve reproductive outcomes, specifically in cases where infertility is linked to isthmocele-related factors, such as challenges during embryo transfer or impaired implantation. However, further well-designed multicenter trials must confirm these findings and provide stronger evidence.Systematic Review Registration https://www.crd.york.ac.uk/prospero/, identifier (CRD42024548864).
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