Outcome of in vitro fertilization after transabdominal ultrasound–assisted embryo transfer with a full or empty bladder (original) (raw)
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Fertility and Sterility, 2011
Objective: To compare pregnancy and implantation rates with transvaginal (TV) versus transabdominal (TA) ultrasound-guided embryo transfer (ET). Design: Randomized, clinical trial registered at clinicaltrials.gov (NCT 01137461). Setting: Private, infertility clinic. Patient(s): Three-hundred thirty randomized recipients of donor oocytes. Intervention(s): Embryo transfer using TV (with empty bladder, using the Kitazato ET Long catheter) versus TA ultrasound guidance (with full bladder, using the echogenic Sure View Wallace catheter). Main Outcome Measure(s): Overall pregnancy, clinical pregnancy, implantation, and ongoing pregnancy rates. Duration and difficulty of ET. Patient-reported uterine cramping and discomfort, as evaluated by questionnaire. Result(s): No statistically significant differences were observed in clinical pregnancy 50.9% versus 49.4% (95% confidence interval of the difference: À9.2 to þ12.2%), implantation 34.5% versus 31.4% (95% CI of the difference: À4 to þ10.3%) between the TV and TA ultrasound-guided groups. Transfer difficulty (6% versus 4.2%) and uterine cramping (27.2% versus 18.3%) were not statistically significantly different between treatment groups. Total duration (154 AE 119 versus 85 AE 76 seconds) was statistically significantly higher in the TV ultrasound group. Light to moderate-severe discomfort related to bladder distension was reported by 63% of the patients in the TA ultrasound group. Conclusion(s): Transvaginal ultrasound-guided ET yielded similar success rates compared with the TA ultrasoundguided procedure without requiring the assistance of a sonographer. It was associated with increased patient comfort due to the absence of bladder distension. (Fertil Steril Ò 2011;-:---.
Journal of advances in medicine and medical research, 2021
Background: Embryo transfer (ET) refers to a step in the process of assisted reproduction in which one or several embryos are placed into the uterus of a female with the intent to establish a pregnancy. This technique, which is often used in connection with in vitro fertilization (IVF), has widely been used in animals or human. The aim of this study was to compare Trans abdominal ultrasound (TAUS) with Trans vaginal ultrasound (TVUS) methods for guidance of (ET) regarding clinical pregnancy rate and patient appreciation of pain during embryo transfer. Methods: This prospective, randomized, controlled study was conducted on 100 patients undergoing cryopreserved or fresh morula or blastocyte who were randomized (computer generated program) into 2 groups. Group I (the study group): 50 patients were subjected to embryo transfer under trans abdominal ultrasound guidance and Group II (controlled group): 50 patients were subjected to (ET) under (TAUS). Results: There were no statistically significant differences regarding fresh and cryopreserved. TVUS group demonstrated significant reduction of duration compared to TAUS ones. Minimal pain
Transabdominal ultrasound–assisted embryo transfer and pregnancy outcome
Fertility and Sterility, 2006
Objective: To assess the clinical value of transabdominal ultrasound (TAS)-assisted embryo transfer on outcomes of in vitro fertilization-embryo transfer (IVF-ET) in comparison to the "clinical touch" method of transcervical embryo transfer by one physician and to determine if transabdominal ultrasound should be applied to all cases of embryo transfer in this practice. Design: A retrospective comparison study. Setting: A university-based IVF practice. Patient(s): Two hundred forty-nine patients who underwent transcervical transfer of fresh embryos created using autologous oocytes performed by the same physician from July 1, 2003, to June 30, 2004. Intervention(s): On selected days, at time of embryo transfer, transabdominal ultrasound was performed to guide catheter placement depth approximately 1 cm from the uterine fundus. Main Outcome Measure(s): The presence of at least one gestational sac on ultrasound was compared in the two study groups; additionally, the clinical pregnancy rate (presence of fetal cardiac activity observed on ultrasound), the ectopic pregnancy rate, the biochemical pregnancy rate, and the implantation rate (number of gestational sacs identified on ultrasound per number of embryos transfered) between groups was evaluated. Characteristics of the two cohorts were analyzed to verify similarities between the treatment and control groups, including age of recipient, prior IVF history, day of transfer (day 3 or day 5 after retrieval), difficulty of transfer, the use of a tenaculum, and the quality and number of embryos transfered.
Embryo transfer: does ultrasound guidance make a difference?
2006
Ever since the birth of the first in-vitro fertilization (IVF) baby in 1978 (1), the advancement in ovulation stimulation regimes, oocyte collection and culture mediums has been phenomenal. However, the technique of uterine embryo transfer remains largely unchanged, since it was first described. The vast majority of transferred embryos fails to implant in spite of improvements in ovulation induction, fertilization and embryo cleavage. On average, up to 90% of apparently healthy zygotes transferred in utero are destined to vanish, giving no signs of trophoblastic attachment and production of human chorionic gonadotrophin (HCG) (2). Though factors relating to the embryo itself (quality, aneuploidy etc), hostile uterine environment (e.g. reflux of hydrosalpinx), inadequate endometrial development or uterine cavity anomalies and uterine contractions contribute to this failure, definitely the technique itself contributes to loss of some potentially favorable embryos for implantation. The...
Is what we clearly see really so obvious? Ultrasonography and transcervical embryo transfer—a review
Fertility and Sterility, 2007
To critically review the role of ultrasound-guided embryo transfer (ET) and its influence on the outcome of in vitro fertilization (IVF). Design: Medline review of published manuscripts. Result(s): Studies evaluating the role of ultrasound-assisted ET have had mixed results, and although metaanalysis of prospective trials suggests an improvement in outcome, limitations in study design may overstate the effect of ultrasonography. Other ET techniques may eliminate the advantages provided by ultrasonography, limiting its benefit to specific clinical scenarios. However, because no trial has demonstrated an adverse effect and because cases that may benefit from its use often cannot be predicted reliably, the routine application of ultrasonography can be justified.
Human Reproduction, 2002
BACKGROUND: Recent reports have suggested that ultrasound (US) guidance during embryo transfer might improve pregnancy rates. METHODS: A prospective randomized (computer-generated random table) trial was performed to compare embryo transfer under abdominal US guidance (n ⍧ 255 women) with clinical touch embryo transfer (n ⍧ 260). RESULTS: The clinical pregnancy rate was 26.3% (67/255) in the US-guided transfer group compared with 18.1% (47/260) in the clinical touch transfer group (P < 0.05). The implantation rate was 11.1% (100/903) in the US group compared with 7.5% (66/884) in the clinical touch group (P < 0.05). US-guided transfer was associated with a decrease in the difficulty of the transfers: 97% of transfers were easy in the US-guided group compared with 81% in the clinical touch group (P < 0.05). CONCLUSIONS: US-guided embryo transfer increased pregnancy and implantation rates in IVF cycles, as well as the frequency of easy transfers. It is suggested that the decrease in cervical and uterine trauma can play a role in the increase in pregnancy rates associated with USguided transfer. It is recommended that embryo transfer should be performed under US guidance.
Ultrasound-guided embryo transfer: immediate withdrawal of the catheter versus a 30 second wait
Human Reproduction, 2001
It is essential to deposit embryos as gently as possible during IVF, avoiding manoeuvres that might trigger uterine contractions which could adversely affect the results of this treatment. The time during which the embryo transfer catheter remains in the cervical canal might be related to stimulation of contractions. This study investigates the influence that the time interval before withdrawal of the catheter after ultrasound (US)-guided embryo deposit might have on the pregnancy rate in patients under IVF cycles. A total of 100 women about to undergo transfer of at least two optimal embryos was studied. The women were prospectively randomized into two groups: (i) slow withdrawal of the catheter immediately after embryo deposit (n ⍧ 51); and (ii) a 30 s delay before catheter withdrawal (n ⍧ 49). The pregnancy rates for transfer in the two groups were 60.8 and 69.4% respectively, with no significant differences. There were no statistically significant differences in pregnancy rates between the two patient groups. The results indicate either that the waiting interval was insufficient to detect differences, or that the retention time before withdrawing the catheter is not a factor that influences pregnancy rate.