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Human Reproduction, Vol. 17, No. 2, 347-350, February 2002
© 2002 European Society of Human Reproduction and Embryology

Transmyometrial embryo transfer and junctional zone contractions

F.P. Biervliet1,3,4, P. Lesny3, S.D. Maguiness1,3, J. Robinson2,3 and S.R. Killick1,3

1 Academic Department of Obstetrics and Gynaecology, 2 Department of Biological Sciences, University of Hull, Cottingham Road, Kingston Upon Hull HU6 7RX and 3 The Hull IVF Unit, Princess Royal Hospital, Saltshouse Road, Kingston Upon Hull HU8 9HE, UK

BACKGROUND: Embryo transfer is a crucial step in IVF–embryo transfer cycles. Several studies have explored transmyometrial embryo transfer, but although this procedure has several favourable characteristics, its role in assisted reproduction has not yet been established. Junctional zone (JZ) contractions during embryo transfer are associated with a negative outcome and factors which increase JZ contractions should be avoided. METHODS: In this study, we have investigated the effect of transmyometrial embryo transfer on JZ contractions. Ten patients with a previously difficult embryo transfer, or a difficult mock embryo transfer, underwent transmyometrial embryo transfer. Before and after this procedure a transvaginal ultrasound scan was performed and this was recorded on videotape for 5 min. The recordings were digitized and then analysed for JZ contractions. RESULTS: Transmyometrial embryo transfer causes a significant increase in JZ contractions. CONCLUSION: The increase in JZ contractions after transmyometrial embryo transfer forms a theoretical objection to this procedure. However, its alternative, a difficult transcervical embryo transfer, is also associated with an increase in JZ contractions. We therefore suggest a large prospective study to investigate the most effective method of embryo transfer in cases where a difficult transcervical embryo transfer is anticipated due to cervical factors.

Key words: difficult embryo transfer/junctional zone contractions/transmyometrial embryo transfer

4 To whom correspondence should be addressed at: The Hull IVF Unit, Princess Royal Hospital, Saltshouse Road, Kingston Upon Hull HU8 9HE, UK. E-mail: f.p.biervliet{at}hull.ac.uk

Submitted on June 22, 2001


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