The changing pattern of uterine contractions before and after fresh embryo transfer and its relation to clinical outcome

• Published in: Reproductive biomedicine online 2017-03, Vol.34 (3), p.240-247
• Main Authors: Chung, Cathy Hoi Sze, Wong, Alice Wai Yee, Chan, Carol Pui Shan, Saravelos, Sotirios H, Kong, Grace Wing Shan, Cheung, Lai Ping, Chung, Jacqueline Pui Wah, Li, Tin Chiu
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Cohort Studies; contraction direction; contraction frequency; Embryo Transfer; Female; Fertilization in Vitro; Humans; Logistic Models; Obstetrics and Gynecology; Pregnancy; Pregnancy Outcome; pregnancy rate; Uterine Contraction; uterine contractions
• ISSN: 1472-6483; 1472-6491
• DOI: 10.1016/j.rbmo.2016.12.011

Abstract In this prospective cohort study of 286 women undergoing fresh embryo transfer after IVF, uterine contraction frequency and direction were measured before (–5 min), 5 min after (+5 min) and 60 min after (+60 min) embryo transfer. Mean + SD uterine contraction frequency at –5 min was 1.8 + 1.1 contractions per min, increasing significantly ( P < 0.05) to 2.0 + 1.1 at +5 min, and returning back to baseline 1.8 + 1.1 at +60 min. At –5 min, the proportion of women the with retrograde, antegrade, indeterminate direction and absent contractions were 33%, 44%, 17% and 6%; at +5 min, 40%, 42%, 13% and 5%, and at +60 min, 42%, 38%, 14% and 6%. No significant change was observed in the proportion of direction at these three time points. Logistic regression analysis showed live birth rate was significantly reduced in older women ( P = 0.035) and in those with higher uterine contraction frequency at +5 min ( P = 0.006). Frequency of uterine contraction immediately after embryo transfer (+5 min) seemed to be a significant predictor of IVF outcome and may help to identify women who could benefit from the use of muscle relaxant therapy to improve outcome.