Isthmocele formation after a previous caesarean section — rather than the C-section itself — lowers the odds of a live birth in women undergoing IVF, research suggests.

Doctors from the University of Perugia in Italy say this association also appears to be “exacerbated” by the accumulation of intracavity fluid (ICF) before embryo transfer.

“We deemed our findings of relevance for reproductive specialists in providing appropriate counselling to and managing patients with a history of previous caesarean section, whether or not associated with isthmocele,” they concluded.

Their meta-analysis and systemic review compared birth rates after an IVF cycle in women with a history of caesarean section with isthmocele to those with prior caesarean delivery without the defect or vaginal delivery.