Aim: To compare classic embryo transfer versus sheath in techniques of embryo transfer. Study Design: Retrospective case control. Materials and Methods: Retrospective case control that was conducted in Multicenter fertility centers. Four thousands one hundred and fifteen infertile women undergoing ICSI with 3110 underwent fresh embryo transfer and 1005 underwent frozen embryo transfer. Sheath in technique conducted by confident positioning of the outer sheath before introducing embryo loaded inner sheath while classic technique both catheters introduced simultaneously. Primary outcomes Clinical pregnancy rate (defined as the presence of pulsating fetal heart after 6-8 weeks of Embryo transfer) in both groups. Results: A total of 3110 embryo transfer were evaluated. in 1767 (56.8% ) classic embryo transfer method was used compared to 1343 (42.2% ) sheath in .The overall pregnancy rate is 50.8 % being 52.5 % within classic embryo transfer compared to 48.6 % within sheath in transfer that was statistically significant. Sheath in embryo transfer yield 51% pregnancy rate in non-difficult embryo transfer ( comparable to classic transfer ) and yield 43.3 % in difficult cases compared to failure of transfer with classic type .Pregnancy rate i8n frozen embryo transfer was significantly higher in sheath in group versus classic transfer (60.6 % versus 52.9%). Conclusion: Sheath in Embryo transfer is a valid technique yield comparable pregnancy rate in non-complicated cases and non-comparable higher pregnancy rate in difficult cases .it is simple a traumatic techniques easy to be standardized
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