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Uterine contractions and embryo transfer: new ultrasound technology is promising to detect the right timing.

Ultrasound speckle tracking technology: a new tool to detect uterine contractions.

Uterine contractions do not happen only when you are about to give birth. During the day, your uterus contracts every little now and then, as a result of various factors, the most important being the stage of your cycle.

The uterus is made up of a strong muscle on the outside, the myometrium, and of a membrane on the inside, which forms a cavity, the endometrium. The uterine muscle contracts increasingly as ovulation is getting closer, in this way, assisting the sperm to reach the egg and fertilise it. Following ovulation, uterine contractions seem to ease off, in an effort to make it easier for the embryo to implant. If no pregnancy happens, the start of your period triggers new contractions, this time directing period blood out of the uterus, as a new cycle is about to begin.

Recent studies have suggested that the uterus not only contracts every now and then during the menstrual cycle, it is also affected by the use of hormonal treatment, as is the case in many fertility treatments and, in particular, during IVF treatment. This effect on the the activity of the uterine muscle has been linked to a decrease in pregnancy rates, following IVF treatment.

Although it is now well recognised as an important factor which affects embryo implantation, the diagnosis of uterine contractions during the cycle has not been an easy task, mainly due to previous tests being quite subjective, expensive, and difficult to repeat.

Now, a new technology, called speckle tracking during ultrasound examination, promises to make the diagnosis of uterine contractions during fertility investigation, as well as IVF treatment, more objective, accurate and quick to carry out. While you are having an ultrasound examination the doctor, or the sonographer, takes a video recording of the uterus for a few minutes. Then the video is analysed with a special computer software that improves the image and provides useful information about uterine contractions.

As the new technology is currently being tested in clinical research, the aim is to make use of it and select the best timing for having an embryo transfer. If uterine contractions have a low strength, then embryo transfer will proceed normally, otherwise, the use of certain medications may help the uterus relax and then allow the embryo transfer to continue. Alternatively, in the event of frequent and strong contractions of the uterus just before the embryo transfer, the embryologists may freeze all your embryos and postpone the embryo transfer for a next cycle.

During the 5th Meeting of the Scientific Society for the Research of Human Reproduction last week in Heraklion, Crete, I had the pleasure to present all this exciting new information on the use of ultrasound technology in detection of uterine contractions. Ultrasound speckle tracking technology is a very promising new tool for the detection of uterine contractions during the menstrual cycle and specifically during IVF treatment. If current studies confirm its value in infertility treatment and mainly in IVF therapy, it will soon be part of the regular check, especially just before the embryo transfer, in order to select the best timing.

©2021, Nicholas Christoforidis, Fertility Matters
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