Objective: To compare ultrasound-guided transmyometrial and transcervical ET in patients with cervical stenosis or in patients who failed to conceive after at least three previous IVF-ET cycles. Design: A prospective, randomized study. Setting: The IVF-ET Unit at Serlin Maternity Hospital. Patient(s): Forty patients undergoing IVF-ET. Intervention(s): Ultrasound-guided transvaginal, transmyometrial, versus transcervical ET. Main Outcome Measure(s): Clinical pregnancy rate. Result(s): Transmyometrial ET was performed in 20 patients and resulted in one clinical pregnancy. Transcervical ET, performed in another 20 similar patients, resulted in three clinical pregnancies. Conclusion(s): No benefit was derived by electing transmyometrial ET in preference to transcervical ET in patients who had failed to conceive in previous cycles.