Fig. 1

Diagram representative of surgical procedure for embryo relocation in a rat model using a bicornuate uterus. (A) Both uterine horns and ovaries were visualized. Green horizontal arrows indicate ovaries and black vertical arrow indicates the corpus and cervix. Bulges in the uterine horns reflect the presence of gestational sacs with maroon crescents indicating placentas. Diagonal lines extending downwards from the uterus reflect mesometrial fat (not included in all images, despite being present in situ). (B) The number of gestational sacs to be relocated was determined and both the uterine horn and mesometrial vessels were ligated superior to the gestational sacs to be relocated (green arrows), as well as inferior to the ovary (not indicated). (C) The ligated portion of the uterine horn (red star) was then excised, preserving the ovary, and the portion of the uterine horn containing the gestational sacs to be relocated was disconnected from as much mesometrial fat as possible (dotted line). The ovary on the original side of the relocated gestational sacs is omitted from future images, but remained in situ. (D) The blood supply from the uterine artery on the cervical side was retained. (E) A longitudinal incision was made along the opposite uterine horn and the contents emptied, creating a “flap”. (F) The gestational sacs to be relocated were rotated so that the placenta(s) were aligned with the mesometrial vessels of the receiving horn. (G & H) Cyanoacrylate surgical glue was used to affix the mesometrial surface of the uterine horn containing the gestational sacs to be relocated to the inner surface of the flap. The flap was brought down and around the gestational sacs and affixed with additional surgical glue to enclose the relocated gestational sacs with the receiving horn. Following the procedure, the cervix remains patent (green arrow).