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Human Reproduction, Vol. 14, No. 9, 2367-2370, September 1999
© 1999 European Society of Human Reproduction and Embryology

Junctional zone contractions and embryo transfer: is it safe to use a tenaculum?

P. Lesny1,3,4, S.R. Killick1,3, J. Robinson2,3, G. Raven3 and S.D. Maguiness1,3

1 Academic Department of Obstetrics and Gynaecology and 2 Department of Biological Sciences, University of Hull, Cottingham Road and 3 The Hull IVF Unit, Princess Royal Hospital, Saltshouse Road, Hull, UK

Applying a tenaculum to the cervix is a common practice when the correction of uterine position prior to embryo transfer is required. Our study was designed to assess junctional zone contractility before and after this procedure in 20 patients at the time of mock embryo transfer (mid-luteal phase, at commencement of down-regulation). Real-time transvaginal ultrasound and computer technology was used to evaluate the contraction pattern and frequency. When a tenaculum was applied, the total number of contractions, the number of cervico–fundal, random and opposing contractions all increased significantly (P values 0.0003, 0.005, 0.001 and 0.007 respectively). Eleven women displayed cervico–fundal contractions, prominent opposing and random contractions were observed in all 20 patients and four patients generated fundo–cervical waves not seen in any case before stimulation with the instrument. In conclusion, manipulation with a tenaculum in the cervical area stimulates junctional zone contractions and is best avoided at the time of embryo transfer.

Key words: embryo transfer/junctional zone contractions/tenaculum/transvaginal ultrasound

4 To whom correspondence should be addressed at: The Hull IVF Unit, Princess Royal Hospital, Saltshouse Road, Hull HU8 9HE, UK


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