Alejandro Kava-Braverman1, Francisca Martínez2, Ignacio Rodríguez2, Manuel Álvarez2, Pedro N Barri2, Buenaventura Coroleu2. 1. Servicio de Medicina de la Reproducción, Department of Obstetrics, Gynecology and Reproduction, Hospital Universitario Dexeus, Barcelona, Spain. Electronic address: alexkava@gmail.com. 2. Servicio de Medicina de la Reproducción, Department of Obstetrics, Gynecology and Reproduction, Hospital Universitario Dexeus, Barcelona, Spain.
Abstract
OBJECTIVE: To establish the relationship between the degree of difficulty of ET and pregnancy rate (PR), with a view to proposing an algorithm for the objective assessment of ET. DESIGN: Retrospective, observational study. SETTING: In vitro fertilization unit. PATIENT(S): Women undergoing assisted reproductive technology (ART) with ET after IVF/intracytoplasmic sperm injection, in whom fresh embryo transfer or frozen-thawed embryo transfer was performed. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Clinical pregnancy rate (CPR). RESULT(S): A total of 7,714 ETs were analyzed. The CPR was significantly higher in the cases of easy ET compared with difficult ET (38.2% vs. 27.1%). Each instrumentation needed to successfully deposit the embryos in the fundus involves a progressive reduction in the CPR: use of outer catheter sheath (odds ratio [OR] 0.89; 95% confidence interval [CI] 0.79-1.01), use of Wallace stylet (OR 0.71; 95% CI 0.62-0.81), use of tenaculum (OR 0.54; 95% CI 0.36-0.79). Poor ultrasound visualization significantly diminish the CPR. CONCLUSION(S): The CPR decreases progressively with the use of additional maneuvers during ET. An objective classification of the instrumentation applied during ET is proposed.
OBJECTIVE: To establish the relationship between the degree of difficulty of ET and pregnancy rate (PR), with a view to proposing an algorithm for the objective assessment of ET. DESIGN: Retrospective, observational study. SETTING: In vitro fertilization unit. PATIENT(S): Women undergoing assisted reproductive technology (ART) with ET after IVF/intracytoplasmic sperm injection, in whom fresh embryo transfer or frozen-thawed embryo transfer was performed. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Clinical pregnancy rate (CPR). RESULT(S): A total of 7,714 ETs were analyzed. The CPR was significantly higher in the cases of easy ET compared with difficult ET (38.2% vs. 27.1%). Each instrumentation needed to successfully deposit the embryos in the fundus involves a progressive reduction in the CPR: use of outer catheter sheath (odds ratio [OR] 0.89; 95% confidence interval [CI] 0.79-1.01), use of Wallace stylet (OR 0.71; 95% CI 0.62-0.81), use of tenaculum (OR 0.54; 95% CI 0.36-0.79). Poor ultrasound visualization significantly diminish the CPR. CONCLUSION(S): The CPR decreases progressively with the use of additional maneuvers during ET. An objective classification of the instrumentation applied during ET is proposed.
Authors: Antonio Stanziano; Anna Maria Caringella; Clementina Cantatore; Giuseppe Trojano; Ettore Caroppo; Giuseppe D'Amato Journal: Reprod Biol Endocrinol Date: 2017-08-14 Impact factor: 5.211