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Volume 7, Issue 5 (September - October 2022)                   J Obstet Gynecol Cancer Res 2022, 7(5): 437-444 | Back to browse issues page

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S. Dawood A, M. Atallah W, M. Assar T. Laparoscopic Tubal Adhesiolysis Versus ICSI in Cases of Post-Cesarean Adhesions: Which Is the Best?. J Obstet Gynecol Cancer Res 2022; 7 (5) :437-444
URL: http://jogcr.com/article-1-562-en.html
1- Department of Obstetrics and Gynecology, Tanta University, Tanta, Egypt , ayman.dawood@med.tanta.edu.eg
2- Department of Obstetrics and Gynecology, Tanta University, Tanta, Egypt
3- Department of Obstetrics and Gynecology, Benha University, Benha, Egypt
Abstract:   (5390 Views)

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 2 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 (47.65%) cases, moderate adhesions in (24.83%) cases and severe adhesions in (27.52%) cases. Pregnancy rates were found to be higher in cases with mild adhesions (62.67%) when compared to cases with moderate or severe adhesions (28.00%) and (9.33%) respectively. The overall pregnancy rate in group 1 was 67 (44.97%), while it was 83 (55.70%) in group 2. The pregnancy rate was higher in group 2 but didn't reach statistical significance. The cost of the procedure was significantly higher in group 2 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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Systematic Review: Original Research | Subject: Reproductive Medicine
Received: 2021/12/3 | Accepted: 2022/02/3 | Published: 2022/07/7

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