{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T15:08:03Z","timestamp":1787843283972,"version":"build-2784847793"},"reference-count":27,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,8,19]],"date-time":"2021-08-19T00:00:00Z","timestamp":1629331200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Cesarean section affects subsequent spontaneous pregnancies because of implantation issues. However, its impact on post\u2010embryo transfer pregnancies is still debated. This review aimed to evaluate the impact of a previous cesarean section on fertility and pregnancy outcomes of women undergoing fresh or frozen embryo transfer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and methods<\/jats:title>\n                    <jats:p>MEDLINE, Scopus, ClinicalTrials.gov, Scielo, EMBASE, Cochrane Library at the CENTRAL, and LILACS were searched from inception to February 2021. Studies were included if they evaluated reproductive or pregnancy outcomes after fresh or frozen embryo transfer in infertile women with a previous cesarean section relative to women with a previous vaginal delivery. Random\u2010effect meta\u2010analyses to calculate risk ratio (RR) or mean differences with 95% confidence intervals (CI) followed by subgroup analysis for fresh and frozen embryo transfer were performed. Risk of bias and quality assessment were conducted using Newcastle\u2013Ottawa scale and GRADE criteria. The review was registered in the International Prospective Register of Systematic Reviews (CRD42021226297).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ten studies, with data provided for 13\u00a0696 participants, were eligible. For embryo transfers after cesarean section, compared with vaginal delivery, there was a significant reduction of the live birth rate (RR 0.88, 95% CI 0.79\u20130.99) and biochemical pregnancy rate (RR 0.89, 95% CI 0.82\u20130.96). No statistically significant differences were found for clinical pregnancy rate (RR 0.92, 95% CI 0.84\u20131.02), ectopic pregnancies (RR 1.00, 95% CI 0.68\u20131.46), pregnancy loss (RR 1.05, 95% CI 0.94\u20131.18), multiple pregnancies (RR 0.80, 95% CI 0.63\u20131.02), stillbirths (RR 0.86, 95% CI 0.27\u20132.69), birth defects (RR 1.71, 95% CI 0.49\u20135.96) or birthweight (mean difference 46.82, 95% CI \u221240.16 to 133.80). Subgroup analysis revealed an increased risk for preterm birth in post\u2010cesarean section fresh embryo transfer pregnancies (RR 1.59, 95% CI 1.16\u20132.19).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Low\u2010grade evidence shows that post\u2010embryo transfer pregnancies in infertile women who had a previous cesarean delivery result in reduced biochemical pregnancy and live birth rates relative to women with a previous vaginal delivery. An increased risk for preterm birth is notable in post\u2010fresh embryo transfer pregnancies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.14239","type":"journal-article","created":{"date-parts":[[2021,8,19]],"date-time":"2021-08-19T21:50:19Z","timestamp":1629409819000},"page":"1949-1960","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Reproductive and pregnancy outcomes following embryo transfer in women with previous cesarean section: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3676-7716","authenticated-orcid":false,"given":"Gaetano","family":"Riemma","sequence":"first","affiliation":[{"name":"Department of Woman, Child, and General and Specialized Surgery University of Campania \u201cLuigi Vanvitelli\u201d Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"De Franciscis","sequence":"additional","affiliation":[{"name":"Department of Woman, Child, and General and Specialized Surgery University of Campania \u201cLuigi Vanvitelli\u201d Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Torella","sequence":"additional","affiliation":[{"name":"Department of Woman, Child, and General and Specialized Surgery University of Campania \u201cLuigi Vanvitelli\u201d Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuliana","family":"Narciso","sequence":"additional","affiliation":[{"name":"Department of Woman, Child, and General and Specialized Surgery University of Campania \u201cLuigi Vanvitelli\u201d Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"La Verde","sequence":"additional","affiliation":[{"name":"Department of Woman, Child, and General and Specialized Surgery University of Campania \u201cLuigi Vanvitelli\u201d Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1304-7575","authenticated-orcid":false,"given":"Maddalena","family":"Morlando","sequence":"additional","affiliation":[{"name":"Department of Woman, Child, and General and Specialized Surgery University of Campania \u201cLuigi Vanvitelli\u201d Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Cobellis","sequence":"additional","affiliation":[{"name":"Department of Woman, Child, and General and Specialized Surgery University of Campania \u201cLuigi Vanvitelli\u201d Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Colacurci","sequence":"additional","affiliation":[{"name":"Department of Woman, Child, and General and Specialized Surgery University of Campania \u201cLuigi Vanvitelli\u201d Naples 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