The Relation between the Position and Length of Uterus and Pregnancy Rate in IVF and Embryo Transfer Treatment Cycles

Embryo transfer has received little clinical attention and has been the most inefficientstep in in-vitro fertilization (IVF). Recent reports have suggested that an awareness of the positionand length of the uterus during embryo transfer might be helpful in improving pregnancy rate.

The main objective of the present study was to determine the relation between thelength and position of the uterus during embryo transfer and pregnancy rate.

Patients were randomly allocated to two groups. In case group A (n=40)length of uterus was measured at the day of oocytes collection and the position of uterus wasdetermined. In the control group, Group B, (n=40) the length and position of uterus were notinvestigated. The embryo transfer catheter was advanced to 5 mm from uterine fondues based onthe previously determined cavity length in group A. The embryo transfer procedures (IVF/ICSI) at48 hours after oocytes collection was done. The outcome of the treatment cycle in two groups wasinvestigated. Data analysis was performed by using chi-square, fisher-exact and ANOVA tests. Thestatistical significant was defined (P≤0.05).

There were no significant differences in the mean age (28.5+4.4, 27.8+6.2), and durationof infertility (7+3.4, 8.7+5.4). The pregnancy rate was not significantly different with respect toposition and length of uterus. The pregnancy rate in case groups was 25% and in control group was22.5%, the difference was not significant (P= 0.792). In both groups, there were ectopic peregnancyand in fact he incidence of ectopic pregnancy, per reported clinical pregnancy, was highest in groupA (14.9%) in comparison with group B (1.8%).

The pregnancy rate was not significantly different in the two groups. Misdirecting theembryo transfer can not be avoided by an accurate knowledge of the position or length of uterine atthe time of oocytes retrieval. Further studies are required to evaluate the role of length and positionof uterus related to the pregnancy rate.