1. TITLE: ENDOMETRIAL CAVITY FLUID Amongst OOCYTE RECIPIENTS: NOVEL INTERVENTIONS AND SUCCESSES; A DIFF HOSPITAL APPROACH
DR ESE WILLIAMS O.

2. OUTLINE BACKGROUND: BRIEF OVERVIEW OF ECF, PREVALENCE IN IVF
OBJECTIVES
SETTING
METHODOLOGY
RESULTS/DISCUSSION
CONCLUSION
REFERENCES

3. BACKGROUND
Endometrial cavity fluid affects approximately 2-5% of patients undergoing IVF (He et al, 2010)
However, report largely on Stimulated cycles
Measurement of fluid in endometrium on day of OCR (akman et al)
Between 1 to <3.5mm in AP diameter (He et al, 2010)
Outcome usually not encouraging, without intervention
With interventions, pregnancy rates quite low < % (he et al 2010, akman et al 2005, mansour et al 1991, chien et al 2002)
Very few studies on oocyte recipients, no meta-analysis
This study, a retrospective study

4. OBJECTIVE
TO EVALUATE LIFE BIRTH RATES AMONGST OOCYTE RECIPIENTS WHO HAD RECURRENT ENDOMETRIAL CAVITY FLUID WITH VARYING INTERVENTIONS

5. METHODOLOGY/SETTING A Retrospective Study
Data Collected From Patients On Art Treatment From 2014 To 2016
Exclusion Criteria: All Hydrosalpinx, Endometriosis, Bulky Uterus With Fibroids Or Adenomyosis, And Evidence Of Endometritis.
Diagnosis Of Fluid During Endometrial Regeneration At Scan Sessions From Days 10 Of Cycle To Day 14 Of Cycle.
Interventions Include: Drainage Of Fluid Alone, Drainage +Insertion Of Intrauterine Contraceptive Devices (IUCD) And Instillation Of HAC +- Drainage/ IUCD At least 48 Hours Prior To Embryo Transfer (ET).
Cycle cancellations when multiple interventions failed
Statistical analysis: Analyse-it® version 4.6 software for Microsoft excel
SETTING; DIFF HOSPITAL. A private hospital in Abuja, FCT of Nigeria.

6. RESULTS/ DISCUSSION
Of the 821 available data from oocyte recipients, 475 (57.8%) had ECF at scans in one or more cycles.
Only 20 (2.4%) of these patients met the inclusion criteria.
Life birth rate was highest amongst the HAC intervention group (33%), followed by Drainage alone (27%), then Drainage + IUCD (25%)
Overall life birth in patients with ECF was 20%, largely age dependent.
Age group ≥ 42 years had the least outcome following interventions

7. Data presentation

8. Successes by intervention table
Interventions
No Life birth
Life birth
Total
%age success
Drainage alone 8 3 11
27%
Drainage + HAC 2 1
33%
Drainage + IUCD 5 6
17%
Grand Total 15 20
77%

9. Successes by age group Age Group No life birth Life birth Total %age
≤32 2 1 3
33%
33-36
14%
37-41 5 7
29%
≥42 6

10. Conclusion Limitations:
Drainage + HAC intervention strategy in patients with ECF has shown to improve life birth rate as compared to other forms of intervention, though this was not statistically significant.
Limitations:
Retrospective study
Final study population after exclusion
Incomplete data entries
Lack of available robust studies on this work

11. Acknowledgements The Medical Director and Director of Admin
The Head of Embryology & Secretary IVF
Research Assistant
All IVF team members
All staff of DIFF Hospital
Medical statistician

12. References
Rong-Huan He, Hui-Juan Gao, Ya-Qiong Li, Xiao-Ming Zhu: The associated factors to endometrial cavity fluid and the relevant impact on the IVF outcome. Reproductive Biology and Endocrinology (RBE), 2010, 8: 46
Akman MA, Erden HF, Bahceci M: Endometrial fluid visualized through ultrasonography during ovarian stimulation in IVF cycles impairs the outcome in tubal factor, but not PCOS, patients. Hum Reprod 2005, 20:
Mansour RT, Aboulghar MA, Serour GI, Riad R: Fluid accumulation of the uterine cavity before embryo transfer: a possible hindrance for implantation. J In Vitro Fert Embryo Transf 1991, 8:
Chien LW, Au HK, Xiao J, Tzeng CR: Fluid accumulation within the uterine cavity reduces pregnancy rates in women undergoing IVF. Hum Reprod 2002, 17:

13. THANK YOU!!!