Human Reproduction, Vol. 17, No. 7, 1767-1772,
July 2002
© 2002 European Society of Human Reproduction and Embryology
Ultrasound measurement of the uterocervical angle before embryo transfer: a prospective controlled study
1 Department of Obstetrics and Gynaecology, the University of Alexandria, and 2 Alexandria Fertility Center, Alexandria, Egypt
BACKGROUND: The study aim was to determine whether moulding the embryo transfer catheter according to the uterocervical angle measured by ultrasound could improve pregnancy and implantation rates. METHODS: Patients were alternately allocated to one of two groups. In the ultrasound-guided group (n = 320), the catheter was moulded according to the uterocervical angle measured by abdominal ultrasound. In controls (n = 320), embryo transfer was performed using the ‘clinical feel’ method. RESULTS: Moulding the embryo transfer catheter according to the uterocervical angle significantly increased clinical pregnancy [(OR = 1.57, 95% CI (1.08–2.27)] and implantation rates [(OR = 1.47, 95% CI (1.10–1.96)] compared with the ‘clinical feel’ method. It also significantly reduced difficult transfers [(OR = 0.25, 95% CI (0.16–0.40)] and blood during transfers [OR = 0.71, 95% CI (0.50–0.99)]. Patients with large angles (>60°) had significantly lower pregnancy rates compared with those with no angle [OR = 0.36, 95% CI (0.16–0.52)]. CONCLUSIONS: Moulding the embryo transfer catheter according to the uterocervical angle measured by ultrasound increases clinical pregnancy and implantation rates and diminishes the incidence of difficult and bloody transfers.
Key words: embryo transfer/IVF/pregnancy rate/ultrasound/uterocervical angle
3 To whom correspondence should be addressed at: 22 Victor Emanuel Square, Smouha, Alexandria, Egypt, 21615. E-mail: hnsallam{at}link.net
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