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What are the prevalence and risk factors of intrauterine adhesions (IUA) in patients with a septate uterus?In this retrospective cohort study, patients with a septate uterus who underwent septum resection between 2015 and 2020 were analysed. Two-dimensional transvaginal ultrasonography plus hysteroscopy was used to diagnose uterine septum or IUA. The prevalence and risk factors for IUA in patients with a septate uterus were examined.Among 522 eligible patients with a septate uterus, 165 patients were diagnosed with IUA (prevalence 31.6% [95% CI 27.7 to 35.5%]). In the multivariable logistic regression analysis of risk factors for IUA, patients who had experienced one or more miscarriages were more likely to have IUA than patients who had not (OR 3.38, 95% CI 1.96 to 5.83, P0.001, and OR 2.55, 95% CI 1.24 to 5.23, P = 0.011, respectively). Patients who underwent one or more dilatation and curettage (DC) procedures had a significantly increased risk of IUA compared with patients who did not (OR 3.42, 95% CI 1.87 to 6.26, P0.001, and OR 3.99, 95% CI 1.93 to 8.26, P0.001, respectively). For patients with a history of miscarriage or DC, the prevalence rates of IUA were 46.5% (95% CI 40.6 to 52.4%) and 44.0% (95% CI 38.5 to 49.5%), respectively.Nearly one-third of patients with a septate uterus have concomitant IUA. A previous miscarriage or DC is an important risk factor for IUA in patients with a septate uterus.

PURPOSE: The study aims to evaluate whether frozen embryo transfer can restore optimal receptivity leading to better assisted reproductive technology outcomes in women with endometriosis. METHODS: This systematic review and meta-analysis, conducted from January 10, 2021 to July 1, 2021, searched the Cochrane Library, PubMed, Embase, Web of Science, OVID, and Clinicaltrials.gov databases from inception to January 10, 2021. The search strategy combined search terms as follows: (“endometriosis” OR “deep endometriosis” OR “endometrioma”) AND (“frozen-thawed embryo transfer” OR “frozen embryo transfer” OR “freeze-all strategy”) AND (“pregnancy outcome” OR “live birth rate” OR “clinical pregnancy rate” OR “miscarriage rate”). No publication time or language limits were set during the searches. In addition, references of the related articles were searched by hand. Patients were included if they had a history of endometriosis and had received fresh or frozen embryo transfer. Only the first transfer cycle was included. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to express outcomes, and data synthesis was conducted using RevMan, version 5.4 software. RESULTS: A total of six studies with moderate methodologic quality were retrieved in the meta-analysis. The studies included 3010 women with endometriosis who wanted to conceive; 1777 (59.0%) had frozen embryo transfer, and 1233 (41.0%) had fresh embryo transfer. There was a significantly higher frequency of live births in the frozen embryo group than in the fresh embryo group (OR, 1.53; 95% CI, 1.13–2.08; P = .007). Despite a similar clinical pregnancy rate in the two groups (OR, 1.26; 95% CI, 0.95–1.69; P = .11), the difference in miscarriage rate was significant (OR, 0.70; 95% CI, 0.50–0.97; P = .03). Evidence quality was considered moderate. CONCLUSION: Cryopreserved embryo transfer has resulted in preferable reproduction outcomes when compared with fresh embryo transfer in patients with endometriosis, but the evidence is not yet abundant. More strictly designed research is needed to evaluate whether frozen embryo transfer leads to better reproductive outcomes in women with endometriosis compared with those receiving fresh embryo transfer. REGISTRATION NUMBER: PROSPERO CRD42021248313.

Acoustofluidic techniques are increasingly used to manipulate nano- and micro-particles in microfluidics. A wide range of acoustofluidic devices consisting of microchannels and acoustic sources have been developed for applications in biochemistry and biomedicine. In this work, two hybrid acoustofluidic devices are developed and modelled, including a double surface acoustic wave (SAW) transducer and a PZT-SAW transducer. The numerical study to these devices demonstrates a higher acoustic pressure present in the microchannel resulting in larger particle velocities in migration to the pressure nodes. The amplitude of the acoustic pressure and the pattern of the pressure distribution can be controlled in the hybrid transducers. By sweeping the height and width of the microchannel, one can identify an optimum dimension to produce intensive acoustic pressure in the PZT-SAW transducer. The particle trajectories reveal that both the SAW-SAW and PZT-SAW configurations produce significantly higher acoustic pressure and particle velocity in the microchannel. This work provides new insights to design acoustofluidic devices with more than one SAW transducer to effectively manipulate micro- and nano-particles.

To explore the impact of concomitant intrauterine adhesions (IUAs) on pregnancy outcomes and obstetric complications in women with a septate uterus.This retrospective cohort included women with a septate uterus, with or without IUAs, between 2015 and 2019 in our hospital. The main outcomes were clinical pregnancy rate, live-birth rate, and obstetric complications.A total of 336 women with a septate uterus-105 women (31.3%) with IUAs and 231 (68.7%) women without IUAs-were analyzed. The rates of clinical pregnancy and live birth among women with moderate-to-severe IUAs were significantly decreased compared with those among women without IUAs (69.9% vs. 76.6%, odds ratio [OR] 0.51; 95% confidence interval [CI] 0.27-0.99, P = 0.046, and 57.0% vs. 67.1%, OR 0.53; 95% CI 0.30-0.95, P = 0.032, respectively). However, these rates were similar between women with mild IUAs and women without IUAs. Women with moderate-to-severe IUAs had a higher incidence of abnormal placentation than women with a septum only (13.2% vs. 1.3%, P = 0.001).Concomitant moderate-to-severe IUAs significantly reduce the rates of clinical pregnancy and live birth and increase the risk of abnormal placentation in subsequent pregnancies in women with a septate uterus.