Impact of a prior cesarean delivery on embryo transfer: a prospective study

A history of cesarean delivery does not significantly affect in vitro fertilization pregnancy outcomes, but embryo transfers are more difficult and likely to have blood or mucus on the catheter.

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Volume 106, Issue 2, Pages 311-316


George Patounakis, M.D., Ph.D., Meghan C. Ozcan, M.D., Rebecca J. Chason, M.D., John M. Norian, M.D., Mark Payson, M.D., Alan H. DeCherney, M.D., Belinda J. Yauger, M.D.



To determine whether a history of prior cesarean delivery (CD) makes ET more difficult and impacts pregnancy outcomes.


Prospective cohort study.


Tertiary care military facility.


One hundred ninety-four patients with previous delivery undergoing IVF/intracytoplasmic sperm injection (ICSI)-ET.



Main Outcome Measure(s)

Live birth (primary), positive hCG, clinical pregnancy, and time to perform ET.


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.


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.

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility┬« is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.