Evaluation of the embryo transfer protocol by a laboratory model of the uterus.
OBJECTIVE
To investigate the dispersion of transferred matter within a uterine laboratory model during and after embryo transfer (ET) as a function of uterine position, catheter placement, and injection speed.


METHODS
Experimental setup.


METHODS
Reproductive bioengineering laboratory.


METHODS
N/A INTERVENTION(S): N/A MAIN OUTCOME MEASURE(S): Laboratory simulations of ET into a rigid transparent uterine model. The catheter was loaded with sequences of liquid and air as in the clinical setting. Experiments were conducted for different inclinations of the uterine model, various transfer speeds of the catheter load, and placement of the catheter tip near and remote from the fundus.


RESULTS
Dispersion of the transferred matter depended on the position of sagittal cross-section of the uterine cavity with respect to the horizon. The air bubbles were pulled up by buoyant forces toward the highest point of the cavity (e.g., the fundus) and thereby dragged behind them the transferred media with the embryos. Placement of the catheter tip near the fundus appeared to transfer the embryos into the tube when transfer was performed at fast speeds, possibly leading to ectopic pregnancies.


CONCLUSIONS
Fundal level of the uterine cavity, location of the catheter tip, and transfer speed determine the potential for embryo implantation. Adjustment of ET protocol to individual patient anatomy is recommended.
Eytan
Osnat
O
Ultrasound Unit in Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Medical Center, Tel Aviv, Israel. osnate@post.tau.ac.il <osnate@post.tau.ac.il>
Elad
David
D
Jaffa
Ariel J
AJ
D000465:Algorithms; D019411:Clinical Laboratory Techniques / Q000295:instrumentation; D003198:Computer Simulation; D004058:Diffusion; D004624:Embryo Transfer; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D008953:Models, Anatomic; D008954:Models, Biological; D013997:Time Factors; D014599:Uterus / Q000502:physiology; D014741:Video Recording / Q000295:instrumentation