MIND THE GAP - ISTHMOCELES AND INFERTILITY
Prior studies have determined that a large isthmocele, an indentation of the myometrium at the site of incision from poor healing of the uterine tissue following Cesarean delivery, produces multiple unfavorable outcomes related to embryo implantation and development. This study enrolled women with unexplained infertility and prior Cesarean delivery resulting in a large isthmocele (residual overlying myometrial thickness of < 3 mm or residual myometrial thickness of <50% of adjacent myometrial tissue) and the primary outcome was endometrial thickness in the presence or absence of intrauterine fluid. Results from this study suggest that presence of an intrauterine fibroid had no significant effect on endometrial thickness (p=0.25), and that there exists a relationship between intrauterine fluid and a slightly longer duration of infertility (24 vs. 27 months; p=0.02).