Intracavitary-Electrohysterogram: Novel technique for assessing uterine peristalsis and electrophysiology in non-pregnant women

Abstract

Background: Uterine peristalsis plays a crucial role in fertility and is affected by various disorders and pathologies. Its knowledge and assessment are very limited with current monitoring techniques.

Objective: The aim is to objectively and quantitatively characterize menstrual uterine peristalsis using a new technique, intracavitary electrohysterogram (IC-EHG).

Methods: This pilot multicenter study recorded IC-EHG by means of a multipolar catheter in a prospective cohort of 15 healthy women with proven fertility across three menstrual phases: mid-follicular (MF), early luteal (EL), and late luteal (LL). To describe and compare uterine peristaltic patterns, characteristics such as contraction frequency, duration, amplitude, and energy were calculated.

Results: The IC-EHG recordings revealed statistically significant patterns throughout the menstrual phases. Uterine contractions were less frequent (3.2 CT/min), more intense and of longer duration during the MF phase. As the menstrual cycle progressed to the EL and LL phases, the frequency of contractions increased (3.7 and 3.5 CT/min, respectively) while both amplitude and duration declined.

Conclusions: The intracavitary electrohysterogram (IC-EHG) effectively quantifies menstrual cycle-dependent uterine peristalsis and electrophysiological patterns, providing initial reference values for uterine bioelectrical activity in fertile women. This novel technique represents a significant advance in assessing uterine physiology, with potential use as a diagnostic tool for real-time uterine health monitoring, supporting gynecological treatment and planning, and aiding in assisted reproductive technologies through objective metrics of uterine activity.

Keywords: Intracavitary electrohysterogram; Menstrual cycle; Uterine contractile function; Uterine contractions; Uterine electrophysiology; Uterine peristalsis.