Nikos Christoforidis, MD, MSc, FRCOG, Obstetrician/Gynaecology Surgeon,
Scientific & Clinical Director at Embryolab, Co-founder of the Embryolab Academy

Uterine contractility is turning into a significant additional factor affecting the chance of successful foetal implantation in IVF treatment.

While normally some uterine contractile activity is observed, depending on which stage of her cycle a woman is, this activity is affected both by the hormonal treatment followed in various assisted reproduction protocols and by abnormal conditions of the uterus, such as the presence of uterine fibroids or adenomyosis.

Until recently, the diagnosis of uterine contractility was mainly based on ultrasound techniques, with several difficulties encountered in the objective interpretation of uterine activity recordings.

With the introduction of speckle-tracking technology in modern ultrasounds, we are now able, on the one hand, to record myometrial activity with greater accuracy and precision and, on the other hand to objectively assess this activity and correlate it to the receptivity of the endometrium.

Prompted by the research activity of F. Sammali in ultrasound speckle-tracking technology in 2018, in partnership with the Eindhoven University of Technology and Catharina Hospital, Embryolab initiated a research protocol to investigate the correlation between uterine contractility and the outcome of the assisted reproduction treatment cycle.

Initially, our aim is to investigate the cases where uterine contractility reduces the chance of successful implantation. In the future, we will examine ways to alter uterine contractility, such as through scheduled cryopreservation and embryo transfer strategy or, later on, through administration of pharmaceutical products that are associated with a decrease in uterine contractility, such as progesterone, oxytocin antagonists, etc.

Ideally, ultrasound examination of uterine contractility before embryo transfer will be the last, yet extremely significant, factor for the successful completion of assisted reproduction treatment.