without a documented pregnancy outcome or ET physician were excluded. All fellow transfers were done with a Wallace catheter using the afterload technique while the attending physician performed abdominal probe ultrasound to ensure proper embryo placement. Data were analyzed by attending physician versus fellow status. All outcomes were evaluated using t-tests, chi squared or regression analysis.RESULTS: A total of 2,477 cycles meeting criteria were identified. Attending physicians performed 2,001 transfers, while fellows performed 476. Attending physicians transferred a larger proportion of grade 1 embryos (62% vs. 56%, p¼ 0.013), while fellows transferred a larger proportion of grade 2 embryos (37% vs. 30%, p¼ 0.009). There were otherwise no differences in cycle characteristics between attending physicians and fellows (Table 1). Additionally, there were no differences in per cycle live birth rates between attending physicians and fellows (30% vs. 28%, p¼ 0.422); this relationship remained true even after adjusting for differences in morphology grading. When data were analyzed by fellowship year, there remained no differences in live birth rates between groups. In particular, the per cycle live birth rate among first year fellows was 30% compared to 32% among attending physicians (p¼ 0.653).CONCLUSIONS: Our data show that there are no differences in live birth rates associated with embryo transfers performed by attending physicians versus fellows. Furthermore, mastery of proper embryo transfer technique is a skill that can be effectively learned during one's first year of fellowship training. We therefore demonstrate that our decade long practice of training fellows to perform embryo transfers does not compromise pregnancy or live birth rates.
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