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Hum. Reprod. Advance Access published online on June 3, 2004
Human Reproduction, doi:10.1093/humrep/deh320
© 2004 by European Society of Human Reproduction and Embryology
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Received October 21, 2003
Accepted April 16, 2004

Article

Cervical dilatation has a positive impact on the outcome of IVF in randomly assigned cases having two previous difficult embryo transfers

N. Prapas 1*, Y. Prapas 2, Y. Panagiotidis 3, S. Prapa 3, P. Vanderzwalmen 4, G. Makedos 5

1 Fourth Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, Thessaloniki, Greece; Iakentro Fertility Center, Thessaloniki, Greece
2 Fourth Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, Thessaloniki, Greece; Iakentro Fertility Center, Thessaloniki, Greece
3 Iakentro Fertility Center, Thessaloniki, Greece
4 Iakentro Fertility Center, Thessaloniki, Greece; SIMAF, Van Helmont Hospital, Vilvoorde, Belgium
5 Fourth Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, Thessaloniki, Greece

* To whom correspondence should be addressed. E-mail: iakentro{at}otenet.gr.


  Abstract

BACKGROUND: The difficulty of embryo transfer has been reported to affect success rates in some centres, but not in others. Cervical dilatation has been proposed as a means to overcome difficult embryo transfer, but consistent criteria for patient selection are lacking. In a prospective randomized study, we examined the influence of cervical dilatation 1-3 months before embryo transfer on the outcome of IVF in cases having difficult embryo transfer in two previously failed IVF cycles. METHODS: Two alternative methods of embryo transfer preparation were evaluated in 283 randomly assigned women having difficult embryo transfers in two previously failed IVF attempts. Randomization was made using a computer-generated random number table. Cervical dilatation before starting any IVF treatment was used in 145 cases, and no dilatation was performed in 138 cases. RESULTS: The cervical dilatation group yielded a significantly higher pregnancy rate than the non-dilated group (40% versus 24%; P<0.01). Likewise, the implantation rate (24.1% versus 14.9%; P<0.01) and the live birth rate (34.48% versus 19.56%; P<0.01) were significantly higher in the dilatation group than in the non-dilated group. CONCLUSIONS: In patients with prior difficult embryo transfer, cervical dilatation 1-3 months before embryo transfer lead to an improved pregnancy rate.

Key words: cervical dilatation, cervical stenosis, embryo transfer, IVF, transfer catheter


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N. Prapas, Y. Prapas, Y. Panagiotidis, S. Prapa, P. Vanderzwalmen, R. Schoysman, and G. Makedos
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[Abstract] [Full Text] [PDF]


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