BACKGROUND: To analyze the effects of embryo transfer (ET) quality on clinical pregnancy (CPR) and live birth delivery rates (LBDR). METHODS: In a retrospective study at a single, private infertility center between November 2005 and December 2009 one thousand fifty-five day-3 and day-5 ETs following IVF/ICSI/IMSI were evaluated. We analyzed the impact of an atraumatic ET with a soft catheter (ET 1), after external guidance (ET 2), after probing of the cervix with a stylet (ET 3), or after grasping the portio vaginalis with a tenaculum (ET 4) on CPR and LBDR. RESULTS: The use of external guidance showed a significantly reduced LBDR as compared to an atraumatic ET (26.0% vs. 32.5%). The lowest CPR and LBDR were found in ET 4. The application of stylets in cases of difficult ETs was superior to the use of external guidance. No differences in miscarriages between ET 1-4 were noted. CONCLUSIONS: Besides embryo culture and patient history, the quality of an ET might also have an important impact on pregnancy outcome. Techniques to ensure an atraumatic ET, such as mechanic uterine cavity length measurements, before starting treatment might help identify patients at risk for a difficult ET and lead to modified treatments, such as the primary use of a stylet. Limitation of study: retrospective analysis.
BACKGROUND: To analyze the effects of embryo transfer (ET) quality on clinical pregnancy (CPR) and live birth delivery rates (LBDR). METHODS: In a retrospective study at a single, private infertility center between November 2005 and December 2009 one thousand fifty-five day-3 and day-5 ETs following IVF/ICSI/IMSI were evaluated. We analyzed the impact of an atraumatic ET with a soft catheter (ET 1), after external guidance (ET 2), after probing of the cervix with a stylet (ET 3), or after grasping the portio vaginalis with a tenaculum (ET 4) on CPR and LBDR. RESULTS: The use of external guidance showed a significantly reduced LBDR as compared to an atraumatic ET (26.0% vs. 32.5%). The lowest CPR and LBDR were found in ET 4. The application of stylets in cases of difficult ETs was superior to the use of external guidance. No differences in miscarriages between ET 1-4 were noted. CONCLUSIONS: Besides embryo culture and patient history, the quality of an ET might also have an important impact on pregnancy outcome. Techniques to ensure an atraumatic ET, such as mechanic uterine cavity length measurements, before starting treatment might help identify patients at risk for a difficult ET and lead to modified treatments, such as the primary use of a stylet. Limitation of study: retrospective analysis.
Authors: Nicolas H Zech; Bernard Lejeune; Francoise Puissant; Sabine Vanderzwalmen; Herbert Zech; Pierre Vanderzwalmen Journal: Fertil Steril Date: 2007-02-08 Impact factor: 7.329
Authors: Evangelos G Papanikolaou; Michel Camus; Efstratios M Kolibianakis; Lisbet Van Landuyt; Andre Van Steirteghem; Paul Devroey Journal: N Engl J Med Date: 2006-03-16 Impact factor: 91.245
Authors: Andrew J Drakeley; Andrea Jorgensen; John Sklavounos; Thomas Aust; Rafet Gazvani; Paula Williamson; Charles R Kingsland Journal: Hum Reprod Date: 2008-03-05 Impact factor: 6.918
Authors: Barbara Wirleitner; Maximilian Schuff; Pierre Vanderzwalmen; Astrid Stecher; Jasmin Okhowat; Libor Hradecký; Tomáš Kohoutek; Milena Králícková; Dietmar Spitzer; Nicolas H Zech Journal: Reprod Biol Endocrinol Date: 2015-07-04 Impact factor: 5.211