ORIGINAL RESEARCH article
Front. Med.
Sec. Obstetrics and Gynecology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1651805
Analysis of Clinical Factors Affecting Pregnancy Outcomes After Embryo Transfer in Patients with Intrauterine Adhesions
Provisionally accepted
- 1Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
- 2Central South University Reproductive and Stem Cell Engineering Institute, Changsha, China
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Abstract Objective To investigate factors influencing embryo transfer success rates after hysteroscopic adhesiolysis in patients with intrauterine adhesions (IUA). Methods A retrospective analysis was conducted on the clinical data of 2,447 patients who underwent hysteroscopy and were diagnosed with intrauterine adhesions (IUA) at our center from January 2023 to December 2023. All patients received adhesion separation surgery and underwent embryo transfer through assisted reproductive technology (ART) after the operation. The patients were divided into non-pregnancy group(n=955) and pregnancy group(n=1,492) based on the pregnancy outcome. The baseline characteristics, degree of intrauterine adhesions, type and duration of balloon placement, time interval from surgery to embryo transfer, number and type of transferred embryos, quality of transferred embryos, and endometrial thickness before transfer were compared between the two groups. Univariate and multivariate regression analysis methods were used to explore the related factors affecting the success rate of embryo transfer. Result Univariate analysis revealed significant associations between pregnancy outcomes and age (OR=0.91, P<0.001), anti-Müllerian hormone（AMH ，OR=1.06, P<0.001), infertility duration (OR=0.96, P=0.044), severe degree of intrauterine adhesion (OR=0.47, P=0.001), balloon placement time (OR=1.01, P=0.002), pre-transplant endometrial thickness (OR=1.24, P<0.001), frozen-thawed embryo transfer (OR=0.38, P<0.001), blastocyst transfer (OR=1.92, P<0.001), and transfer of high-quality embryos(OR=1.30,P=0.002）were significantly associated with pregnancy outcomes. Multivariate analysis further clarified the independent effects of age (OR=0.92,P<0.001),severe degree of intrauterine adhesion(OR=0.31,P=0.001),endometrial thickness before embryo transfer(OR=1.19, P<0.001),blastocyst transfer (OR=2.03, P<0.001), and transfer of high-quality embryos(OR=1.36, P=0.001)on pregnancy outcomes. Conclusion Age, pre-transplant endometrial thickness, severe intrauterine adhesions, blastocyst transfer, and transfer of high-quality embryos are independent factors associated with pregnancy outcomes following intrauterine adhesion separation and subsequent embryo transfer.
Keywords: Intrauterine adhesions, Embryo Transfer, Pregnancy Outcome, Clinical pregnancy rate, live birth rate
Received: 22 Jun 2025; Accepted: 08 Oct 2025.
Copyright: © 2025 Liu, Chen, Lin, Wang, Ban, Zhong and Sun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hui Chen, cch1966421@163.com
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