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Research Papers

Modeling Embryo Transfer into a Closed Uterine Cavity

[+] Author and Article Information
Sarit Yaniv

 Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv 69978, Israel

Ariel J. Jaffa

 Ultrasound Unit in Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel-Aviv 64239; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel

David Elad1

 Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv 69978, Israelelad@post.tau.ac.il

1

Corresponding author.

J Biomech Eng 134(11), 111003 (Oct 26, 2012) (7 pages) doi:10.1115/1.4007628 History: Received January 17, 2012; Revised August 13, 2012; Posted September 25, 2012; Published October 26, 2012; Online October 26, 2012

Embryo transfer (ET) is the last manual intervention after extracorporeal fertilization. After the ET procedure is completed, the embryos are conveyed in the uterus for another two to four days due to spontaneous uterine peristalsis until the window time for implantation. The role of intrauterine fluid flow patterns in transporting the embryos to their implantation site during and after ET was simulated by injection of a liquid bolus into a two-dimensional liquid-filled channel with a closed fundal end via a liquid-filled catheter inserted in the channel. Numerical experiments revealed that the intrauterine fluid field and the embryos transport pattern were strongly affected by the closed fundal end. The embryos re-circulated in small loops around the vicinity where they were deposited from the catheter. The transport pattern was controlled by the uterine peristalsis factors, such as amplitude and frequency of the uterine walls motility, as well as the synchronization between the onset of catheter discharge and uterine peristalsis. The outcome of ET was also dependent on operating parameters such as placement of the catheter tip within the uterine cavity and the delivery speed of the catheter load. In conclusion, this modeling study highlighted important parameters that should be considered during ET procedures in order to increase the potential for pregnancy success.

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Copyright © 2012 by American Society of Mechanical Engineers
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Figures

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Figure 1

Schematic description of the two-dimensional channel with an opening in the fundus for simulation of embryo transport within the sagittal cross-section of the uterine cavity during and post embryo transfer (ET). The full line shows the cavity at t = 0, while the dashed line shows the cavity at t = T/4 (where T is the period of one oscillation). The parameters are defined in the text.

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Figure 2

The profiles of axial velocity ux during the 5th cycle for the reference case (case #1 in Table 1). The profiles are depicted along the channel at: (a) x = 25 mm; (b) x = 28 mm; (c) x = 30 mm; (d) x = 31 mm; (e) x = 37.5 mm; (f) x = 43.8 mm; (g) x = 47 mm. At each location the profiles are given at T/8 time intervals. The dimensionless time is defined by θ = t/T.

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Figure 3

Trajectories of massless particles initially located at the catheter tip (i.e., x = 30 mm) at y = 0, 0.1, 0.2, 0.3 mm. The trajectories for the reference case (case #1 in Table 1) are shown during: (a) ten cycles; (b) 40 cycles after embryo transfer (ET) ended. The trajectories were generated from 200 points per cycle. The initial location of each particles is marked by a circular symbol (○) filled with the trajectory color. The final location of each particle is marked by a diamond symbol (◊) filled with the trajectory color. The location of each particle at the end of the injection is marked by rectangular symbol (□) filled with the trajectory color. The channel walls are shown at the onset of injection by a continuous line and the end of the injection by the dashed line.

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Figure 4

Trajectories of massless particles for different cases: (a) reference case (case #1), (b) b = 0.3 mm (case #2), (c) T = 10 s (case #3), (d) Umax  = 5 mm/s (case #4), (e) ℓ = 40 mm (case #5)

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Figure 5

Trajectories of massless particles along ten cycles for different synchronizations between wall motility and onset of injection of the catheter load given by the phase shift τ: (a) τ = 0 (case #6; Table 1); (b) τ = 9 s (reference case #1)

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