Evidence map›Paper›PMID 41694264›Full record

ArticleF&S reports2026

Frozen embryo transfer outcomes in patients with prior cesarean delivery: a focus on endometrial lining parameters.

Emily A Clarke, Jing Wu, Hannah Milad, Kerry Flannagan, Jiarui Wang, Joseph Lee, Luis Hoyos, Meike Uhler, Michael Homer, Jenna Friedenthal and 3 more

Abstract read
In one paragraph

Article in F&S reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Emily A ClarkeDepartment of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York.
Jing WuUS Fertility, Rockville, Maryland.
Hannah MiladLoyola University Medical Center, Maywood, Illinois.
Kerry FlannaganUS Fertility, Rockville, Maryland.
Jiarui WangUS Fertility, Rockville, Maryland.
Joseph LeeReproductive Medicine Associates of New York, New York.
Luis HoyosIVF Florida Reproductive Associates, Margate, Florida.
Meike UhlerFertility Centers of Illinois, Chicago, Illinois.
Michael HomerReproductive Science Center, San Francisco, California.
Jenna FriedenthalReproductive Medicine Associates of New York, New York.
Alan B CoppermanDepartment of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York.
Phillip RomanskiReproductive Medicine Associates of New York, New York.
Mary MorrisShady Grove Fertility, Towson, Maryland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: To evaluate the association between prior mode of delivery (cesarean vs. vaginal) and endometrial thickness in the subsequent frozen embryo transfer (FET) cycle. The secondary aim was to evaluate FET cycle outcomes. Design: Retrospective cohort study. Subjects: This multicenter study included patients with one previous live birth who initiated a subsequent, autologous FET cycle from January 2012 to December 2024. Patients were grouped by mode of prior delivery: cesarean or vaginal. Exposure: Cesarean or vaginal delivery. Main Outcome Measures: The primary outcome was endometrial thickness at final lining assessment. Secondary outcomes included FET cycle cancellation rate due to thin or fluid-filled endometrium, pregnancy, and live birth rates. Subgroup analyses evaluated outcomes of euploid FET cycles only. Results: A total of 11,131 FET cycles consisting of 5,149 from patients with prior cesarean and 5,982 from patients with prior vaginal delivery were included. Endometrial thickness in the subsequent FET cycle was similar between cohorts (cesarean: 10.4 mm [10.3-10.5 mm]; vaginal: 10.4 mm [10.3-10.4 mm]). The FET cycle cancellation rate due to thin endometrium was comparable (cesarean: 1.3%, vaginal: 1.2%; adjusted relative risk [aRR] 1.02 [0.72-1.43]); cancellation due to endometrial fluid accumulation was higher in the cesarean cohort (1.0% vs. 0.5%; aRR 2.22 [1.40-3.58]). Cesarean delivery was associated with lower live birth (49.5% vs. 53.0%; aRR 0.95 [0.90-0.98]) and clinical pregnancy (60.5% vs. 64.1%; aRR 0.95 [0.90-0.99]), with similar rates of clinical pregnancy loss (cesarean: 10.6%, vaginal: 10.6%; aRR 0.95 [0.84-1.07]). Similar trends were observed in patients undergoing euploid FET, with lower live birth demonstrated in those with a prior cesarean (55.3% vs. 60.3%; aRR 0.91 [0.84-0.98]), but similar chance of clinical pregnancy loss (cesarean: 9.1%, vaginal: 9.4%; aRR 0.95 [0.77-1.17]). Conclusion: Although patients can be reassured that a prior cesarean does not appear to be associated with reduced endometrial thickness, receptivity in FET cycles may be diminished, as reflected by lower subsequent live birth rates. One possible explanation is an altered endometrial environment, given the increased risk of cycle cancellation due to endometrial fluid accumulation in patients with prior cesarean delivery.

Indexed as

Cesarean deliveryendometrial receptivityendometrial thicknessfrozen embryo transferlive birth rates

Identifiers

PMID41694264
PMCPMC12905608

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.