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


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


  1. Schmidt L., et al. “Infertility and the seeking of infertility treatment in a representative population”. BJOG: An International Journal of Obstetrics and Gynaecology 102 (1995): 978-984.
  2. Bushnik T., et al. “Estimating the prevalence of infertility in Canada”. Human Reproduction 27 (2012): 738-746.
  3. Cai X., et al. “A cross-sectional study on the current status of female infertility in three counties of Xinjiang Uygur Autonomous Region”. Zhonghua Yu Fang Yi Xue za Zhi 91 (2011): 3182-3185.
  4. Dunson DB., et al. “Increased infertility with age in men and women”. Obstetrics and Gynecology 103 (2004): 51-56.
  5. Ray A., et al. “Unexplained infertility: an update and review of practice”. Reproductive BioMedicine Online6 (2016): 591-602.
  6. Rogers PA., et al. “A model to show human uterine receptivity and embryo viability following ovarian stimulation for in vitro fertilization”. Journal of In Vitro Fertilization and Embryo Transfer 3 (1986): 93-98.
  7. Madani T., et al. “Appropriate timing of uterine cavity length measurement positively affects assisted reproduction cycle outcome”. Reproductive BioMedicine Online5 (2009): 734-736.
  10. Jurkovic D., et al. “Three-dimensional ultrasound for the assessment of uterine anatomy and detection of congenital anomalies: a comparison with hysterosalpingography and two-dimensional sonography”. Ultrasound in Obstetrics and Gynecology4 (1995): 233-237.
  11. Krampl E., et al. “Transvaginal ultrasonography sonohysterography and operative hysteroscopy for the evaluation of abnormal uterine bleeding”. Acta Obstetricia et Gynecologica Scandinavica7 (2001): 616-622.
  12. Kamel HS., et al. “Comparison of transvaginal ultrasonography and vaginal sonohysterography in the detection of endometrial polyps”. Acta Obstetricia et Gynecologica Scandinavica1 (2000): 60-64.
  13. Pundir J and El Toukhy T. “Uterine cavity assessment prior to IVF”. Women's Health6 (2010): 841-848.
  14. Faivre E., et al. “Accuracy of three-dimensional contrast hysterosonography in diagnosis and classification of uterine congenital anomalies”. Ultrasound in Obstetrics and GynecologyS1 (2009): 29-29.
  15. Sher G and Fisch JD. “Measuring uterine depth with colpohydrosonography”. The Journal of Reproductive Medicine5 (2003): 325-329.
  16. Fatemi HM., et al. “Prevalence of unsuspected uterine cavity abnormalities diagnosed by office hysteroscopy prior to in vitro fertilization”. Human Reproduction8 (2010): 1959-1965.
  17. Chan YY., et al. “The prevalence of congenital uterine anomalies in unselected and high-risk populations: a systematic review”. Human Reproduction Update6 (2011): 761-771.
  18. Guimarães Filho HA., et al. “Prevalence of uterine defects in habitual abortion patients attended on at a University Health Service in Brazil”. Archives of Gynecology and Obstetrics 274 (2006): 345-348.
  19. Ajayi AB., et al. “Abnormal Sonohysterography among Sub-Fertile Black Women in Sub-Saharan Africa”. Journal of Reproductive Medicine Gynaecology and Obstetrics 6 (2021): 070.
  20. Alatas C., et al. “Evaluation of intrauterine abnormalities in infertile patients by sonohysterography”. Human Reproduction3 (1997): 487-490.
  21. Ajayi AB., et al. “Laparoscopic Myomectomy: A 6-Year Experience at Nordica Fertility Center, Lagos, Nigeria”. Medical and Clinical Reviews1 (2016): 1-11.
  22. Brown SE., et al. “Evaluation of outpatient hysteroscopy, saline infusion hysterosonography, and hysterosalpingography in infertile women: a prospective, randomized study”. Fertility and Sterility5 (2000): 1029-1034.
  23. Goldstuck N. “Assessment of Uterine Cavity Size and Shape: A Systematic Review Addressing Relevance to Intrauterine Procedures and Events”. African Journal of Reproductive Health3 (2012): 129-138.
  24. Abd-Ellah A., et al. “Hysteroscopic Evaluation of The Uterine Cavity After Intracytoplasmic Sperm Injection and Embryo Transfer Failure: Is It Rewarding?” The Journal of The Egyptian Society of Gynaecology and Obstetrics2 (2011): 619-623.
  25. Mishra VV., et al. “Uterine cavity assessment prior to in vitro fertilization: comparison of 3D transvaginal ultrasonography accuracy versus office hysteroscopy”. Indian Journal of Obstetrics and Gynecology Research3 (2016): 270-227.
  26. Ryley DA., et al. “Influence of body mass index (BMI) on the outcome of 6827 IVF cycles”. Fertility and Sterility2 (2004): S38-S39.
  27. Aghajanova L., et al. “Effect of body mass index (BMI) on oocyte quality in IVF cycles”. Fertility and Sterility3 (2015): E115.
  28. Wittemer C., et al. “Does Body Mass Index of Infertile Women Have an Impact on IVF Procedure and Outcome?” The Journal of Assisted Reproduction and Genetics 17 (2000): 547-552.
  29. Kasius JC., et al. “Observer agreement in the evaluation of the uterine cavity by hysteroscopy prior to in vitro fertilization”. Human Reproduction4 (2011): 801-807.
  30. Jia G., et al. “A case report on Herlyn-Werner-Wunderlich syndrome with spontaneous abortion”. Medicine36 (2018): e12004.
  31. Pope CS., et al. “Influence of embryo transfer depth on in vitro fertilization and embryo transfer outcomes”. Fertility and Sterility1 (2004): 51-58.
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.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

September Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the September issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before October 14, 2022.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.