Laparoscopic Tubal Adhesiolysis Versus ICSI in Cases of Post-Cesarean Adhesions: Which Is the Best?
Publish Year: 1401
نوع سند: مقاله ژورنالی
زبان: English
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شناسه ملی سند علمی:
JR_JOGCR-7-5_010
تاریخ نمایه سازی: 11 مرداد 1401
Abstract:
Background & Objective: Secondary infertility resulting from tubal adhesions following cesarean section are not uncommon. The decision to do adhesiolysis or direct IVF/ICSI is to some extent difficult. This study was conducted to evaluate the benefits/risks of either adhesiolysis or direct IVF/ICSI for patients with secondary infertility due to post-cesarean tubal adhesions.
Materials & Methods: Three hundred infertile women with post-cesarean adhesion were recruited and divided into ۲ groups either laparoscopic adhesiolysis or ICSI procedure.
Results: Demographic data of enrolled patients in both groups were comparable. Regarding types of adhesions, mild adhesions were found in (۴۷.۶۵%) cases, moderate adhesions in (۲۴.۸۳%) cases and severe adhesions in (۲۷.۵۲%) cases. Pregnancy rates were found to be higher in cases with mild adhesions (۶۲.۶۷%) when compared to cases with moderate or severe adhesions (۲۸.۰۰%) and (۹.۳۳%) respectively. The overall pregnancy rate in group ۱ was ۶۷ (۴۴.۹۷%), while it was ۸۳ (۵۵.۷۰%) in group ۲. The pregnancy rate was higher in group ۲ but didn't reach statistical significance. The cost of the procedure was significantly higher in group ۲ but with significantly lower complication rates.
Conclusion: Although assisted reproduction gives the patient higher pregnancy rates with less possibility of complications, it should not be considered the first-choice treatment for patients with post-cesarean adhesions, especially in mild and moderate cases.
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Authors
Ayman S. Dawood
Department of Obstetrics and Gynecology, Tanta University, Tanta, Egypt
Walid M. Atallah
Department of Obstetrics and Gynecology, Tanta University, Tanta, Egypt
Tamer M. Assar
Department of Obstetrics and Gynecology, Benha University, Benha, Egypt
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