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Table 1 Characteristics of included studies

From: Lower pregnancy rate in women with high uterine peristalsis before embryo transfer: a systematic review and meta-analysis

First author, Year of publication

Country

Study design

Population

Age, yrs (mean ± SD)

Cause of sterility

Treatment cycle

CPR

Endometrium thickness on embryo transfer day (mm)

Frequency (contr./min)

Direction

Serum E2 (pg/ml)

Serum P (ng/ml)

(ET on day 2–3)

Serum FSH ( IU/L)

Serum LH (IU/L)

Serum E2 (pg/ml)

Serum P (ng/ml) (Day 5)

Narayan et al.,1994 [20]

United Kingdom

prospective

112

Conception group: 34.1 ± 4.23

Non-conception group: 34.2 ± 4.59

Tubal (48.2%)

Male factor (11.6%)

Unexplained infertility (25.9%)

Endometriosis (7.1%)

PCOS (4.5%)

Premature menopause (2.7%)

IVF: COH and FET cycles

30.36%

not reported

COH: 1.59 ± 1.08

FET: 1.74 ± 0.86

HRT/FET cycles: 1.44 ± 1.29

COH:

Retrograde 37.1%

Antegrade 35.7%

Indeterminate 27.2%

FET:

Retrograde: 46.7%

Antegrade: 33.3%

Indeterminate: 20.0%

HRT/FET:

Retrograde: 100%

not reported

not reported

Ayoubi et al.,2003 [6]

France and Switzerland

prospective crossover trial

6

28–35 (31.8)

Male factor (100%)

Group A: Natural Cycle (without IVF Treatment)

Group B: IVF: COH Long protocol

33.33%

not reported

A: 5.3 ± 0.7

B: 0.5 ± 1

not reported

not reported

not reported

Ijland et al.,1998 [21]

Netherlands

prospective

19

26–36 (32)

not reported

IUI

not reported

not reported

not reported

not reported

not reported

not reported

Fanchin et al.,1998 [22]

France

prospective

209

23–38

Tubal (40%)

Male factor (45%)

Unexplained infertility (12%)

Endometriosis (3%)

IVF: COH Agonist Protocol

not reported

 ≤ 3 UC/min: 9.8 ± 0.3

3.1–4 UC/min: 9.2 ± 0.3

4.1–5 UC/min: 9.4 ± 0.4

 > 5 UC/min: 9.9 ± 0.3

4.3 ± 0.1

Retrograde 15%

Antegrade 28%

Antagonistic 11%

Non-propagated 6%

CP:

Serum P (ng/ml)

 < 3.0 UC/min group: 0.96 ng/ml;

3.1–4.0 UC/min group: 0.77 ng/ml;

4.1–5.0 UC/min group: 0.81 ng/ml

 > 5.0 UC/min group: 0.74 ng/ml

Serum E2 (pg/ml):

 < 3.0 UC/min group: 2589 pg/ml

3.1–4.0 UC/min group: 2449 pg/ml

4.1–5.0 UC/min group: 2754 pg/ml

 > 5.0 UC/min group: 2376 pg/ml

not reported

Ijland et al.,1999 [23]

Netherlands

prospective

28

25–38 (32)

Tubal (35.7%)

Endometriosis (3.5%)

Male factor (13.28%)

Unexplained subfertility (46.4%)

IVF: COH Agonist Long- protocol

39%

13.4 ± 3.9

CF waves:

7.11 ± 4 (on hCG -6)

6, 9.4 ± 5.7 on the (day of hCG)

10.1 ± 5.0 (day of ET)

FC waves:

8.12 ± 4.5 (on hCG -6)

7.15 ± 5.2 (day of hCG)

Absent FC:

P: 35.7%

NCP: 14.3%

Present FC:

P: 3.5%

NCP: 25%

not reported

not reported

Fanchin et al.,2000 [24]

France

prospective

59

23–38

Tubal abnormalities (39%)

Sperm abnormalities (54%)

Unexplained infertility (5%)

Endometriosis (2%)

IVF: COH Agonist Protocol

Low P group: 27%

CPR: 18%

high P group: 46%

CPR: 35%

not reported

Day HCG: 4.6 ± 0.2

Day ET: 4.2 ± 0.2

Day of hCG administration:

Retrograde (CF) 62%

Antegrade (FC) 27%

Antagonistic 9%

non-propagated, 2%

Day of ET:

Retrograde (CF) 61%

Antegrade (FC) 24%

Antagonistic 14%

non-propagated 1%

hCG administration:

Serum E2

Low P: 2 150 ± 124 pg/ml

High P: 3 043 ± 240 pg/ml

Serum Progesterone

Low P: 1065 ± 76 pg/ml

High P: 1189 ± 86 pg/ml

On the day of embryo transfer:

Serum E2

Low P: 1065 ± 76 pg/ml

High P: 1189 ± 86 pg/ml

Serum Progesterone

Low P: 61.9 ng/ml (7.4–98.0)

High P: 128.8 ng/ml (102.9–232.0)

not reported

Vlaisavljevic et al.,2001 [25]

Slovenia

prospective

122

not reported

not reported

IVF: COH

23.8%

P: 12.2 ± 2.2

NCP: 11.9 ± 2.7

not reported

Day of cycle + 6:

antegrade 11.1

retrograde 18.5

both 15.2

CP:

Day of cycle + 2

Serum P (nmol / L) 115.4 ± 57.6

Serum E2 (nmol / L) 1.8 ± 1.4

NCP:

Day of cycle + 2

Serum P(nmol / L) 102.6 ± 55.1

Serum E2 (nmol / L) 2.5 ± 5.5

CP:

Day of cycle + 6

Serum P (nmol / L) 147.5 ± 45.5

Serum E2(nmol / L) 3.1 ± 2.3

Day of cycle + 12

Serum P (nmol / L) 131.3 ± 65.4*

Serum E2 (nmol / L) 2.2 ± 1.9*

NCP:

Day of cycle + 6

Serum P (nmol / L) 134.1 ± 48.5

Serum E2 (nmol / L) 3.5 ± 3.8

Day of cycle + 12

Serum P (nmol / L) 17.4 ± 33.7

Serum E2 (nmol / L) 0.6 ± 1.1

Vangestel et al.,2005 [26]

Netherlands

prospective

90

22–41 (33)

Tubal pathology (13.33%)

endometriosis (2.22%)

male factor infertility (58.88%)

unexplained subfertility (25.55%)

IVF: COH

30.23%

not reported

not reported

CF 32.1%

FC 55.9%

not reported

not reported

Kim et al., 2013 [27]

Korea

Observational study

243

Conception group (49): 31.43 ± 3.06

Non-conception group (192): 32.86 ± 3.56

unexplained infertility (100%)

CC 100 mg, IUI

NP: 79.66%

P: 20.33%

not reported

NCP: 3.46 ± 1.89

P: 4.02 ± 1.44

NCP:

CF: 75.5%

FC: 89.8%

P:

CF: 24.5%

FC: 10.2%

not reported

not reported

Zhu et al.,2014 (Nov 2013) [9]

China

prospective

112

not reported

not reported

IVF: COH

44.9%

not reported

2.24 ± 0.74 waves/min

not reported

not reported

not reported

Zhu et al., 2014 [9]

China

prospective

292

20–35

29.1 ± 3.5

not reported

IVF: COH long agonist protocol

Natural FET

HRT FET

53.42%

CP: 11.3 + 2.7

NCP: 11.2 + 3.0

Fresh cycles: 1.80 ± 0.77

Natural FET: 2.05 ± 0.80

HRT FET: 2.15 ± 0.81

not reported

CP:

Serum E2 (pg/ml) 1068.3 + 973.0

Serum P (ng/ml) 56.3 + 11.5

Fresh cycle 58.3 + 9.3

Natural FET cycle 53.2 + 13.6

Artificial FET cycle 53.0 + 14.5

NP:

Serum E2 (pg/ml) 947.1 + 903.6

Serum P (ng/ml) 52.8 + 15.2

Fresh cycle 59.0 + 7.2

Natural FET cycle 48.4 + 16.4

Artificial FET cycle 43.8 + 20.0

not reported

Chung et al.,2017 [28]

China

prospective

286

CP: 34.6 ± 3.0

NCP: 35.1 ± 3.4

Ovulatory problem (4.6%)

Tubal (50.5%)

Male factor (28.9%)

Endometriosis (7.1%)

Unexplained (8.8%)

COH: Long protocol vs antagonist protocol

42%

1% (ectopic pregnancy)

32.5% (LBR)

CP: 11 ± 0.2

NCP: 11 ± 0.3

 − 5 min: 1.8 ± 1.1

 + 5 min: 2.0 ± 1.1

 + 60 min: 1.8 ± 1.1

–5 min

Retrograde: 41.3%

Antegrade: 43.5%

Indeterminate: 38.8%

Nil: 44.4%

 + 5 min

Retrograde: 43.9%

Antegrade: 39.5%

Indeterminate: 37.8%

Nil: 61.5%

 + 60 min

Retrograde: 40.8%

Antegrade: 32.1%

Indeterminate: 70.6%

Nil: 60%

CP:

Serum E2 (pmol/L)

5928.8 ± 3030.8

Serum Progesterone (nmol/L)

304.2 ± 140.3

NCP:

Serum E2 (pmol/L) 5629.1 ± 3720.5

Serum Progesterone (nmol/L)

261.2 ± 133.5

not reported

Samara et al., 2019 [29]

Israel

retrospective

224

Control: 35.1 ± 3.7

MatrisTM scoring: 35.2 ± 3.7

not reported

FET cycles

44.3% (Control)

42% (MatrisTM scoring)

38.2% (Waves Group)

Control: 9.3 ± 1.8

Waves group: 9.4 ± 2.5

MatrisTM scoring: 9.4 ± 2

not reported

not reported

not reported

not reported

Blank et al.,2020 [14]

Netherlands

prospective

16

Ongoing pregnancy: 29.9 ± 3.9

No ongoing pregnancy: 33.9 ± 4.6

Male factor (50%)

Tubal (12.5%)

Unexplained infertility (25%)

Hormonal disorders (18.75%)

Recurrent miscarriage (6.25%)

COH: Agonist vs antagonist Protocol

43.8% (fresh SET with a day-5 embryo)

56.3% (positive HCG test at a gestational age of 6 weeks, ongoing implantation)

Overall: 9.2 ± 2.8

Ongoing pregnancy: 8.8 ± 1.6

No ongoing pregnancy: 9.4 ± 3.9

1 h before ET:

Ongoing implantation group: 1.35 ± 0.44

Ongoing pregnancy group: 1.45 ± 0.42

No ongoing implantation group: 0.91 ± 0.19

No ongoing pregnancy group: 0.93 ± 0.22

5–7 days after ET:

Ongoing implantation group: 0.050 Hz ± 0.005

Ongoing pregnancy group: 0.050 Hz ± 0.004

No ongoing implantation group: 0.045 Hz ± 0.004

No ongoing pregnancy group: 0.045 Hz ± 0.005

not reported

E2:

Total: 1115 (210–2630)

Ongoing pregnancy: 1240 (1030–2630)

No ongoing pregnancy: 842 (210–1450)

Progesterone:

Total: 0.3 (0.15–1.23)

Ongoing pregnancy: 0.3 (0.15–0.75)

No ongoing pregnancy: 0.31 (0.15–1.23)

E2:

Total: 153 (25–486)

Ongoing pregnancy: 326 (70–486)

No ongoing pregnancy: 25 (25–44)

Progesterone:

Total: 15 (8–71)

Ongoing pregnancy: 16 (13–37)

No ongoing pregnancy: 13 (8–71)

Anshikha et al., 2021 [30]

India

prospective

60

20–45

33.33 ± 5.22

Poor ovarian reserve (45%)

Tubal (18.3%)

COH:Antagonist protocol

FET HRT

38.3%

not reported

56.7%: > 3/2 min

20%: < 3/2 min

not reported

not reported

not reported

Masroor et al.,2023 [31]

Iran

prospective

68

25–40

not reported

FET HRT cycle

36.8%

7–15

9.02 ± 2.2

PR: 2.2 ± 1.6

NPR: 3.3 ± 1.2

not reported

not reported

not reported

Li et al.,2023

China

prospective

230

20–35

Unexplained infertility (0.9%)

Male factor (6.1%)

Female factor (46.1%)

Male and female factor (47%)

COH

68.7%

Total: 11.26 ± 2.14

NPR: 11.44 ± 2.28

PR: 11.18 ± 2.08

Total: 2.90 ± 1.44

NPR: 2.86 ± 1.56

PR: 2.92 ± 1.38

not reported

not reported

not reported

  1. Summary of cohort studies investigating uterine contractility and implantation rate and male outcomes
  2. Abbreviations: IVF In vitro fertilization, COH Controlled ovarian hyperstimulation, FET frozen embryo transfer, IUI (insemination), HRT (Hormone replacement therapy), CP (clinical pregnancy), NCP (no clinical pregnancy), LBR (live birth rate), PCOS (Polycystic ovary syndrome), CF (cervix fundus), FC (fundus cervix), E2 (estrogen), P (progesterone), FSH (follicle stimulating hormone), LH (Luteinizing hormone) UC/min ( uterine contractions/ minute)