ORIGINAL RESEARCH article
Front. Surg.
Sec. Obstetrics and Gynecological Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1671347
Cesarean section history affects the outcomes of frozen embryo transfer in IVF/ICSI: A retrospective study
Provisionally accepted
Xiaohui Wang1
Yan Zhou2*- 1Zhejiang University School of Medicine, Hangzhou, China
- 2Henan Provincial People's Hospital, Zhengzhou, China
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Objective: Cesarean section (CS) rates have risen globally, with cesarean scar defect (CSD) being a common complication. Few studies have investigated the impact of CSD on in vitro fertilization/intracytoplasmic sperm injection frozen embryo transfer (IVF/ICSI-FET) outcomes. This study assessed how prior CS history (with or without CSD) affects IVF/ICSI-FET outcomes compared with prior vaginal delivery (VD). Methods: We retrospectively analyzed 985 IVF/ICSI-FET patients: 597 patients with prior VD (VD group) and 388 with prior CS (CS group). The CS group was subdivided into those without CSD (NCSD, n=283) and those with CSD (CSD, n=105). Binary logistic regression was used to assess the associations between delivery history and pregnancy outcomes. Results: No significant differences in early abortion, premature birth, perinatal complications or birth weight were detected between the VD and CS groups. However, compared with the VD group, the CS group had significantly lower biochemical pregnancy, implantation, live birth, and clinical pregnancy rates. Among women with prior CS, the CSD group had significantly higher rates of premature birth and perinatal complications than the NCSD group did. The size of the CSD did not affect the live birth rate or clinical pregnancy rate. Conclusions: Prior CS negatively affects IVF/ICSI-FET pregnancy outcomes. The presence of CSD further increases premature birth and perinatal complication rates.
Keywords: Cesarean Section, scar defect, Frozen embryo transfer, in vitro fertilization, Pregnancy Outcome
Received: 22 Jul 2025; Accepted: 29 Sep 2025.
Copyright: © 2025 Wang and Zhou. 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: Yan Zhou, zh_yan1991@163.com
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