Research Article
Volume 11 Issue 7 - 2022
Assessment of the Depth of Uterine Cavity Prior to In-Vitro Fertilization in Black African Women
Abayomi B Ajayi1, Bamgboye M Afolabi2,3*, Victor D Ajayi1, Ifeoluwa O Oyetunji1, Arati Sohoni1 and Usman Yakubu1
1Nordica Fertility Center, Norman-Williams Street, South-west Ikoyi Lagos, Nigeria
2Nigerian Institute of Medical Research, Edmond Crescent, Yaba, Lagos, Nigeria
3Health, Environment and Development Foundation, Ogunfunmi Street, Surulere, Lagos Nigeria
*Corresponding Author: Bamgboye M Afolabi, Nigerian Institute of Medical Research, Edmond Crescent, Yaba and Health, Environment and Development Foundation, Ogunfunmi Street, Surulere, Lagos Nigeria.
Received: April 30, 2022; Published: June 28, 2022




Abstract

Introduction: Uterine cavity provides suitable site and environment for the implantation of a fertilized ovum and development of the embryo.  Uterine cavity abnormalities can be a contributing cause of sub-fertility and recurrent implantation failure due to distortion of the anatomy of the cavity. 

Purpose of Study: The relevance, importance and influence of the depth of placement of embryos into the uterine cavity has been reported by several authors. Some have suggested placing the embryos 1 - 1.5 cm short of the uterine fundus. Others have suggested better implantation rates with mid-cavity placements as higher placements may increase risk of ectopic pregnancies. Knowing the depth of the uterine cavity (DOUC), which can also be influenced by uterine pathology is important in In-vitro fertilization (IVF) practice and embryo transfer for best outcome.

Materials and Methods: This was a retrospective study of 1122 patients who presented for Assisted Reproductive Technology (ART) at Nordica Fertility Center in Nigeria between 2003 and 2014. Only Black African women with complete records and who presented solely for fertility management were included. All patients had either sonohysterogram or hysteroscopy to determine uterine cavity depth and the state of uterine cavity. Analysis was conducted with NCSS21 statistical software. Study was approved by the Nigerian Institute of Medical Research Review Board (NIMR-IRB-18-006).

Results: When the mean DOUC (cm) of those ≤ 35 years was compared to that of women aged >35 years, there was no observable variation; but overall remarkable difference was observed when the mean DOUC (cm) was assessed by BMI in which those with BMI < 18.5 (n = 12, 1.1%) had mean DOUC of 8.6 cm (F-test = 11129.9, P-value << 0.001). Regardless of age, those who had uterine fibroid alone (in ≤ 35 years, n = 28; in > 35 years, n = 101) had remarkable variation (t-statistic = -2.38, P-value = 0.02; t-statistic = -3.07, P-value = 0.02) in mean DOUC (9.3 ± 2.4 cm; 8.7 ± 1.5 cm respectively) compared with those without any uterine pathology. Mean DOUC (8.7 ± 1.2 cm) of women aged > 35 years was notably longer (t-statistics= 2.54, P-value = 0.01) in those who had uterine polyps (n = 69) than the mean DOUC (8.2 ± 1.5 cm) of those with no uterine pathology (n = 316). Overweight (n = 56) and obese (n = 31) women with uterine fibroid alone were observed to have significantly longer (t-statistic = 2.36, P-value = 0.02; t-statistics = -2.41, P-value = 0.02 respectively) DOUC (8.9 ± 2.1 and 8.8 ± 1.2 cm respectively) than the DOUC of their counterpart with no uterine pathology. Uterine fibroid alone contributed a significant 2.0% (R2 = 0.020, F = 22.49, P-value < 0.001) and polyps alone also contributed a significant 0.5% (R2 = 0.005, F = 6.09, P-value = 0.014) to the variations observed in DOUC.

Conclusion: Knowledge of the details of uterine cavity depth and shape could make it easier to deposit the embryo at an optimum depth within the cavity, this may influence the chances of implantation during IVF treatment. From the comparative analysis of the Depth of uterine cavity in black African women, there is significant correlation between depth of uterine cavity and age. The mean depth of uterine cavity is significantly longer among women who had history of uterine fibroid, polyp and curettage compared to women with no history of uterine pathology or intervention. The age of the study subjects was significantly associated with the mean depth of uterine cavity more than their BMI.

Keywords: Black African; Depth of Uterine Cavity; Uterine Pathology; Uterine Surgery

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Citation: Bamgboye M Afolabi., et al. “Assessment of the Depth of Uterine Cavity Prior to In-Vitro Fertilization in Black African Women”. EC Gynaecology 11.7 (2022): 08-24.

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