How useful is cervical dilatation in patients with cervical stenosis who are participating in an in vitro fertilization-embryo transfer program? the bourn hall experience

Optimizing the technique of embryo transfer

“…If the trial reveals a cervix too stenotic to permit passage of the catheter, cervical dilatation can be planned well before the ET. Techniques for cervical dilatation that have been described include mechanical dilation (12)(13)(14), use of osmotic dilators such as Laminaria (15,16), placement of a Malecot catheter (17,18), and operative hysteroscopic shaving (19). In our center we have found that Laminaria is an effective method for most cases and can be accomplished with minimal anesthesia.…”

“…Dilatation at stimulation start allows sufficient time for the endometrium to recover from any trauma, inflammation, or bacterial contamination before ET. In cases of cervical stenosis, lower PRs are associated with cervical dilatation done within 5 days of transfer (4,14); however, dilatation several weeks before ET appears to improve PRs (12,13,15,16).…”

Effect of the afterloaded external guidance embryo transfer technique on pregnancy rates in single embryo transfer cycles

“…There have been studies comparing the effect of different transfer catheters, different operators or transfer type on outcome. Although Burke reported that the difficult ET did not affect the clinical pregnancy rate, Abusheika found that a difficult embryo transfer technique negatively affects pregnancy rates (8,9). On the other hand, a meta-analysis by Abou-Setta demonstrated that softer catheters are associated with higher clinical pregnancy rates than firmer catheters by overall comparison (10).…”

Assisted Reproduction

“…123 Other methods including cervical dilation and resection to improve ease of transfer have also been reported. 124 …”