title: Ultrasound measurement of the uterocervical angle before embryo transfer: a prospective controlled study.
abstract: 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 degrees ) 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.
authors.affiliation: Department of Obstetrics and Gynaecology, Alexandria Fertility Center, University of Alexandria, 22 Victor Emanuel Square, Smouha, Alexandria, Egypt 21615.
authors.forename: H N
authors.initials: HN
authors.lastname: Sallam
authors.forename: A F
authors.initials: AF
authors.lastname: Agameya
authors.forename: A F
authors.initials: AF
authors.lastname: Rahman
authors.forename: F
authors.initials: F
authors.lastname: Ezzeldin
authors.forename: A N
authors.initials: AN
authors.lastname: Sallam
mesh_terms: D002404:Catheterization; D002584:Cervix Uteri / Q000000981:diagnostic imaging*; D010064:Embryo Implantation; D004624:Embryo Transfer / Q000009:adverse effects / Q000295:instrumentation; D004867:Equipment Design; D005260:Female; D006801:Humans; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D014463:Ultrasonography; D014592:Uterine Hemorrhage / Q000209:etiology / Q000517:prevention & control; D014599:Uterus / Q000000981:diagnostic imaging*