Investigators: Dr Michelle Dunn (1), A/Prof Luk Rombauts (1,2), Caroline Motteram (2), Dr Shavi Fernando (1)
1 Monash Dept Obstetrics and Gynaecology, Clayton; 2 Monash IVF, Clayton
There is some evidence that the thickness of the endometrium may be associated with poorer outcomes following IVF. For example, a very thin endometrium may be associated with a slightly lower pregnancy rate. A thicker endometrium on the other hand has been associated with higher pregnancy rates following IVF but also with an increased rate of placenta previa, a condition where the placenta is attached too low in the uterus. This happens in 1 in 250 naturally conceived pregnancies.
This project is investigating the subtle muscle contractions of the uterus known as “uterine peristalsis” during the time of implantation of a fertilised embryo into the uterus. It is thought that these contractions may be more prominent in women with a thicker endometrium. Although we don’t know for sure, these contractions may have the potential to shift the embryos into a different spot than where it was deposited. Our study hypothesises that the thickness of the endometrial lining is related to these contractions; i.e. the thicker the endometrial lining the higher the frequency of the contractions.
If a relationship between the thickness of the endometrium is linked to the uterine contractions it could potentially explain why embryos sometimes implant low in the uterine cavity or in rare circumstances end up implanting in the fallopian tube as an ectopic pregnancy. Additionally, this may lead to future studies looking at screening for and potentially treating higher risk women with medications to decrease uterine muscle activity at the time of transfer.
Recruitment for this study is ongoing and is offered to patients receiving treatment at our Clayton clinic.