Cervical mucus removal prior to embryo transfer in women undergoing in vitro fertilization intracytoplasmic sperm injection A systematic review and meta analysis of randomized controlled trials

There is very little evidence of an overall benefit of cervical mucus removal before embryo transfer for women undergoing in vitro fertilization/intracytoplasmic sperm injection.

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Laurentiu Craciunas, Dr.-Medic., Nikolaos Tsampras, Cheryl Fitzgerald, M.B., Ch.B., M.D.

Volume 101, Issue 5, Pages 1302–1307.e6



To appraise critically the published randomized controlled trials (RCTs) reporting on the effectiveness of cervical mucus removal before embryo transfer.


Systematic review and meta-analysis of RCTs.


Assisted reproduction technology (ART) units.


Women undergoing embryo transfer after in vitro fertilization/intracytoplasmic sperm injection (IVF-ICSI).


Cervical mucus removal followed or not by cervical irrigation immediately before embryo transfer.

Main Outcome Measure(s):

Clinical pregnancy, implantation and live-birth rates.


Eight RCTs involving 1,715 women were systematically analyzed. There was substantial heterogeneity among the included trials. There was no statistically significant difference in terms of pregnancy, implantation, or live-birth rates.


A meta-analysis from the available moderate to low quality trials provides very little evidence of an overall benefit of cervical mucus removal before embryo transfer for women undergoing IVF/ICSI. Due to problems of clinical diversity, statistical heterogeneity, and risk of bias, additional pragmatic multicenter RCTs are needed to evaluate the possible small benefit of cervical mucus removal before embryo transfer.

Read the full text at: http://www.fertstert.org/article/S0015-0282(14)00095-8/fulltext

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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