151 INTRODUCTION: In a healthy uterus, rhythmic contractions change in rhythm and intensity during the menstrual cycle to support sperm propagation and embryo implantation (83,215–217). However, no study thus far has been able to comprehensively characterise all aspects of uterine contractions during the menstrual cycle; therefore, these characteristics remain largely speculative, based on heterogenous studies. Furthermore, research into its characteristics has been hampered by the subjectivity of the available measurement tools (83). It has been suggested that aberrant uterine peristalsis or ‘dysperistalsis’ is associated with reduced fertility and/or symptoms such as dysmenorrhoea (218,219). Up to now, there exists no quantifiable marker for dysperistalsis, this being varyingly defined by previous investigators. Multiple methods have been used to visualise and assess uterine contractions and their different characteristics, one of which is transvaginal ultrasound (TVUS). A recent study, however, showed that medical professionals shared only mild agreement on the direction and timing of uterine peristalsis by subjective visual inspection of TVUS recordings (220). Although visual inspection of TVUS can give a number of peristalsis parameters (frequency and direction), it is generally qualitative and unsuitable to quantify contraction amplitude or velocity. Furthermore, contraction coordination – being the synchronised movement of the anterior and posterior walls of the uterus – has never been investigated. There is thus a need for an objective, quantifiable method for uterine contraction assessment, preferably in a non-invasive, operator- and patient-friendly manner. Recently published data by our group presented a novel method for assessing uterine contractility, using 2D TVUS and speckle tracking techniques (221– 224). This has been tested and (externally) validated in IVF patients prior to embryo transfer (225,226). This method is able to quantitatively assess features such as contraction frequency and amplitude, in addition to a novel set of features: contraction coordination, direction, and velocity. Coordination is defined as the synchronised simultaneous movement of the anterior and posterior uterine walls; where the value reflects the degree of synchronicity of coordination. This aspect of uterine movement is potentially of clinical relevance for the assessment of (normal) uterine function.
RkJQdWJsaXNoZXIy MTk4NDMw