title: The changing pattern of uterine contractions before and after fresh embryo transfer and its relation to clinical outcome.
abstract: In this prospective cohort study of 286 women undergoing fresh embryo transfer after IVF, uterine contraction frequency and direction were measured before (-5 min), 5 min after (+5 min) and 60 min after (+60 min) embryo transfer. Mean ± SD uterine contraction frequency at -5 min was 1.8 ± 1.1 contractions per min, increasing significantly (P < 0.05) to 2.0 ± 1.1 at +5 min, and returning back to baseline 1.8 ± 1.1 at +60 min. At -5 min, the proportion of women the with retrograde, antegrade, indeterminate direction and absent contractions were 33%, 44%, 17% and 6%; at +5 min, 40%, 42%, 13% and 5%, and at +60 min, 42%, 38%, 14% and 6%. No significant change was observed in the proportion of direction at these three time points. Logistic regression analysis showed live birth rate was significantly reduced in older women (P = 0.035) and in those with higher uterine contraction frequency at +5 min (P = 0.006). Frequency of uterine contraction immediately after embryo transfer (+5 min) seemed to be a significant predictor of IVF outcome and may help to identify women who could benefit from the use of muscle relaxant therapy to improve outcome.
authors.affiliation: Department of Obstetrics and Gynaecology, 1E, Block EF, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong.
authors.forename: Cathy Hoi Sze
authors.initials: CH
authors.lastname: Chung
authors.affiliation: Department of Obstetrics and Gynaecology, 1E, Block EF, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong.
authors.forename: Alice Wai Yee
authors.initials: AW
authors.lastname: Wong
authors.affiliation: Department of Obstetrics and Gynaecology, 1E, Block EF, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong.
authors.forename: Carol Pui Shan
authors.initials: CP
authors.lastname: Chan
authors.affiliation: Department of Obstetrics and Gynaecology, 1E, Block EF, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong.
authors.forename: Sotirios H
authors.initials: SH
authors.lastname: Saravelos
authors.affiliation: Department of Obstetrics and Gynaecology, 1E, Block EF, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong.
authors.forename: Grace Wing Shan
authors.initials: GW
authors.lastname: Kong
authors.affiliation: Department of Obstetrics and Gynaecology, 1E, Block EF, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong.
authors.forename: Lai Ping
authors.initials: LP
authors.lastname: Cheung
authors.affiliation: Department of Obstetrics and Gynaecology, 1E, Block EF, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong.
authors.forename: Jacqueline Pui Wah
authors.initials: JP
authors.lastname: Chung
authors.affiliation: Department of Obstetrics and Gynaecology, 1E, Block EF, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong. Electronic address: tinchiu.li@gmail.com.
authors.forename: Tin Chiu
authors.initials: TC
authors.lastname: Li
mesh_terms: D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D016015:Logistic Models; D011247:Pregnancy; D011256:Pregnancy Outcome; D014590:Uterine Contraction
keywords: contraction direction; contraction frequency; embryo transfer; pregnancy rate; uterine contractions