title: Bioengineering studies of the embryo transfer procedure.
abstract: Embryo transfer (ET) is the final manual intervention in extracorporeal fertilization in which an embryo is transferred into the uterus by a transcervical catheter. The low rates of embryo implantation within the uterus are attributed, among other factors, to the ET technique, which depends on a multitude of anatomical, physiological, and mechanical aspects. We developed computational and experimental models to simulate ET to examine the contribution of mechanical features to the success of this procedure. The experimental model allowed laboratory simulations of the dispersion of the catheter load as a result of different injection speeds into a tilted uterine model. The mathematical model analyzed potential trajectories of the transferred embryos resulting from the interaction between the injection velocity and the intrauterine flows caused by uterine peristalsis. The simulations revealed the important contribution of mechanical parameters, such as the position of the uterus and the presence of air in the catheter load. The latter was found to increase the potential for the embryo to be near the fundal area during the time limit for implantation. Based on the results of our simulations, we recommended performing ET in a patient-specific position in which the fundus will be the highest point above the horizon and that the load be delivered slowly, that is, not less than 10 s. We also recommended placing the tip of the catheter at the mid cavity to avoid ectopic pregnancy.
authors.affiliation: Ultrasound Unit in Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Medical Center, Tel Aviv 64239, Israel. osnate@post.tau.ac.il
authors.forename: Osnat
authors.initials: O
authors.lastname: Eytan
authors.forename: David
authors.initials: D
authors.lastname: Elad
authors.forename: Ariel J
authors.initials: AJ
authors.lastname: Jaffa
mesh_terms: D001698:Biomedical Engineering / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D003198:Computer Simulation / Q000706:statistics & numerical data; D004624:Embryo Transfer / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008954:Models, Biological