Uterine peristalsis and fertility: current knowledge and future perspectives: a review and meta-analysis

N.P. Kuijsters, Willem Methorst, Madeleine Susanne Quirine Kortenhorst, Chiara Rabotti, Massimo Mischi, B.C. Schoot
In: Reproductive BioMedicine Online · 2017 · vol. 35(1) , pp. 50–71 · doi:10.1016/j.rbmo.2017.03.019 · PMID:28456372 · W2605960183
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-12 ⓘ

This review and meta-analysis examines how uterine peristalsis affects fertility, finding that progesterone and prostaglandins may improve outcomes, and highlighting the need for better measurement tools and further research.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-12 · read from full text ⓘ

This review summarizes current literature on uterine peristalsis (UP) and its effects on pregnancy chances in both natural and assisted reproduction, highlighting that UP is influenced by factors including uterine pathologies and hormones while its physiological basis is not fully understood. The authors also report a meta-analysis of therapeutic approaches that interfere with uterine contractions, finding positive results for progesterone given at embryo transfer in IVF cycles and for prostaglandins given at intrauterine insemination, while noting that the overall evidence quality is low and likely limited to selected patients with abnormal contraction patterns. A key limitation emphasized is that UP remains incompletely characterized, and the field lacks an objective, user-friendly measuring tool for routine practice. Relevance to endometriosis: the paper discusses uterine pathologies as influences on uterine peristalsis and fertility outcomes, though it does not specifically focus on endometriosis or adenomyosis.

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Abstract

Although uterine contractions in the non-pregnant uterus have been studied extensively, the knowledge gained has not been used in general fertility treatment work-up. In this review paper, we provide an overview of the current knowledge on uterine peristalsis (UP), based on the available literature. This literature shows that UP influences pregnancy chances in both natural and artificial cycles. Although the physiological background of these contractions is not completely clear, we know that several factors can be of influence, like uterine pathologies and hormones. Several options to alter pregnancy outcome by interfering with uterine contractions have been studied. Our meta-analysis on therapeutic options shows positive results of progesterone at time of embryo transfer in IVF cycles or prostaglandins at time of intrauterine insemination, although the quality of evidence is low. These therapies are probably most beneficial in selected groups of patients with abnormal contraction patterns. The introduction of an objective and user-friendly UP measuring tool suitable for use in daily practice would make it possible to identify and monitor these patients. We suggest that future research should focus on the physiology of initiation of UP and on the development of an effective standard measuring tool.
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Abstract

Although uterine contractions in the non-pregnant uterus have been studied extensively, the knowledge gained has not been used in general fertility treatment work-up. In this review paper, we provide an overview of the current knowledge on uterine peristalsis (UP), based on the available literature. This literature shows that UP influences pregnancy chances in both natural and artificial cycles. Although the physiological background of these contractions is not completely clear, we know that several factors can be of influence, like uterine pathologies and hormones. Several options to alter pregnancy outcome by interfering with uterine contractions have been studied. Our meta-analysis on therapeutic options shows positive results of progesterone at time of embryo transfer in IVF cycles or prostaglandins at time of intrauterine insemination, although the quality of evidence is low. These therapies are probably most beneficial in selected groups of patients with abnormal contraction patterns. The introduction of an objective and user-friendly UP measuring tool suitable for use in daily practice would make it possible to identify and monitor these patients. We suggest that future research should focus on the physiology of initiation of UP and on the development of an effective standard measuring tool. | Original language | English | |---|---| | Pages (from-to) | 50-71 | | Number of pages | 22 | | Journal | Reproductive BioMedicine Online | | Volume | 35 | | Issue number | 1 | | DOIs | | | Publication status | Published - 1 Jul 2017 |

Keywords

- IVF - assisted reproduction - infertility - meta-analysis - uterine contractions - uterine peristalsis - Progestins/therapeutic use - Humans - Progesterone/therapeutic use - Embryo Transfer - Fertility - Uterus/anatomy & histology - Female - Peristalsis/drug effects Fingerprint Dive into the research topics of 'Uterine peristalsis and fertility: current knowledge and future perspectives: a review and meta-analysis'. Together they form a unique fingerprint.Cite this - APA - Author - BIBTEX - Harvard - Standard - RIS - Vancouver

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