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Difficult Transfers
2. Whatarestrategiesyouuseforpatient’snextcyclewith a prior very difficult transfer?
‐ mock transfer to map cervix: 34%
‐ dilation prior to start of cycle: 22%
‐ dilation at time of retrieval: 21%
‐ hysteroscopic Tx: 9%
‐ schedule transfer under anesthesia: 9%
‐ other: laminaria, relaxants, cervical suture: 7%
Additional strategies
Other strategies at time of transfer
• Ask for help
• Varying patient position (e.g., knee chest) • Using os finder for slight dilation
• Last resort at time of transfer:
– Tenaculum or cervical suture (rarely) Strategies before next transfer
• Pre‐cyclelaminaria
• Dilation or hysteroscopy
• Misoprostol
• Placementofcervicalsuture
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PRECONGRESS COURSE 15 I VIENNA, AUSTRIA – 23 JUNE 2019 37