title: Cervical dilatation has a positive impact on the outcome of IVF in randomly assigned cases having two previous difficult embryo transfers.
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.
authors.affiliation: Fourth Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, Thessaloniki, Greece. iakentro@otenet.gr
authors.forename: N
authors.initials: N
authors.lastname: Prapas
authors.forename: Y
authors.initials: Y
authors.lastname: Prapas
authors.forename: Y
authors.initials: Y
authors.lastname: Panagiotidis
authors.forename: S
authors.initials: S
authors.lastname: Prapa
authors.forename: P
authors.initials: P
authors.lastname: Vanderzwalmen
authors.forename: G
authors.initials: G
authors.lastname: Makedos
mesh_terms: D000328:Adult; D002404:Catheterization; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D007747:Labor Stage, First; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome