title: Impact of a prior cesarean delivery on embryo transfer: a prospective study.
abstract: OBJECTIVE
  To determine whether a history of prior cesarean delivery (CD) makes ET more difficult and impacts pregnancy outcomes.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Tertiary care military facility.
  
  
  METHODS
  One hundred ninety-four patients with previous delivery undergoing IVF/intracytoplasmic sperm injection (ICSI)-ET.
  
  
  METHODS
  None.
  
  
  METHODS
  Live birth (primary), positive hCG, clinical pregnancy, and time to perform ET.
  
  
  RESULTS
  There was no statistically significant difference between patients with a history of only vaginal deliveries versus those with a history of CD for live birth (39% vs. 32%), positive hCG (56% vs. 53%), or clinical pregnancy (49% vs. 41%). Embryo transfers took longer in the history of CD group (157 vs. 187 seconds) and were more likely to have mucus (27% vs. 45%) or blood (8% vs. 21%) on the catheter.
  
  
  CONCLUSIONS
  Embryo transfers performed on patients with a prior CD took 30 seconds longer. They were also more likely to have blood or mucus on the catheter. Despite the apparently more difficult transfers, pregnancy outcomes were not different between the two groups.
authors.affiliation: National Institutes of Health/National Institute of Child Health and Human Development, Bethesda, Maryland.
authors.forename: George
authors.initials: G
authors.lastname: Patounakis
authors.affiliation: Walter Reed National Military Medical Center, Bethesda, Maryland.
authors.forename: Meghan C
authors.initials: MC
authors.lastname: Ozcan
authors.affiliation: Walter Reed National Military Medical Center, Bethesda, Maryland.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Chason
authors.affiliation: HRC Fertility, Pasadena, California.
authors.forename: John M
authors.initials: JM
authors.lastname: Norian
authors.affiliation: Dominion Fertility, Arlington, Virginia; Inova Fairfax Hospital Women's Center, Falls Church, Virginia.
authors.forename: Mark
authors.initials: M
authors.lastname: Payson
authors.affiliation: National Institutes of Health/National Institute of Child Health and Human Development, Bethesda, Maryland.
authors.forename: Alan H
authors.initials: AH
authors.lastname: DeCherney
authors.affiliation: Walter Reed National Military Medical Center, Bethesda, Maryland. Electronic address: belinda.j.yauger.mil@mail.mil.
authors.forename: Belinda J
authors.initials: BJ
authors.lastname: Yauger
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects; D004624:Embryo Transfer / Q000009:adverse effects; D005260:Female; D005298:Fertility; D005307:Fertilization in Vitro; D006772:Hospitals, Military; D006801:Humans; D007246:Infertility / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D008396:Maryland; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D011446:Prospective Studies; D012307:Risk Factors; D020554:Sperm Injections, Intracytoplasmic; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome
keywords: Embryo transfer; IVF; cesarean delivery; cesarean scar