Non-Invasive Isthmocele Treatment: A New Therapeutic Option During Assisted Reproductive Technology Cycles?

BACKGROUND: The objective of the study was to evaluate a new medical treatment strategy for infertile patients with isthmocele. METHODS: This was a retrospective evaluation of the records of infertile patients with symptomatic isthmocele who received non-invasive isthmocele treatment (NIIT) before in vitro fertilization (IVF) treatment cycles. Isthmocele volumes were measured before and after NIIT. The IVF results and isthmocele-related complaints were also analyzed. The patients were treated with a depot gonadotropin-releasing hormone agonist for 3 months before frozen-thawed embryo transfer cycles. RESULTS: The mean isthmocele volume was 471.06 ± 182.81 mm(3) (range: 289.43 - 765.4 mm(3)) in fresh cycles, but was reduced to 47.94 ± 29.48 mm(3) (range: 18.70 - 105.6 mm(3)) in frozen-thawed cycles (P < 0.05). Intrauterine fluid was observed in two patients during fresh cycles, but was absent after NIIT during frozen-thawed cycles. There was no brown bloody discharge on the tip of the embryo transfer catheter in any case after NIIT. Two patients became pregnant and underwent term cesarean delivery (25%). CONCLUSIONS: NIIT can serve as an alternative pretreatment option for patients with isthmocele during IVF cycles.