title: Transmyometrial embryo transfer and junctional zone contractions.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Academic Department of Obstetrics and Gynaecology, Department of Biological Sciences, University of Hull, Cottingham Road, Kingston Upon Hull HU6 7RX , UK. f.p.biervliet@hull.ac.uk
authors.forename: F P
authors.initials: FP
authors.lastname: Biervliet
authors.forename: P
authors.initials: P
authors.lastname: Lesny
authors.forename: S D
authors.initials: SD
authors.lastname: Maguiness
authors.forename: J
authors.initials: J
authors.lastname: Robinson
authors.forename: S R
authors.initials: SR
authors.lastname: Killick
mesh_terms: D000328:Adult; D004624:Embryo Transfer / Q000009:adverse effects*; D005260:Female; D006801:Humans; D009215:Myometrium; D014463:Ultrasonography; D014590:Uterine Contraction; D014599:Uterus / Q000000981:diagnostic imaging; D014743:Videotape Recording