In this study, we retrospectively analysed data from 877 patients who had 1204 embryo transfer procedures following in-vitro fertilization (IVF) at Midland Fertility Services, UK, between January 1991 and December 1995 to investigate the factors contributing to failure of embryo transfer at first attempt and the impact of immediate retransfer of retained embryos on the treatment outcome. Embryos were significantly more likely to be retained when the embryo transfer catheter was contaminated with mucus (3.3 versus 17.8%, P = 0.000001) or blood (3.3 versus 12%, P = 0.00001) and when the transfer procedure was difficult compared with when it was easy (20.3 versus 0.8%, P = 0.00001). There was no significant difference in the clinical pregnancy rate between those who had all their embryos transferred at the first attempt (24.7%) and those who required more than one attempt (23.2%). The types of embryo transfer catheter used in the unit did not show any difference in terms of embryo retention. Although we recommend aspiration of cervical mucus in order to reduce the rate of retained embryos, there is no evidence from our study to suggest that pregnancy rate is compromised when embryos are retained, provided they are discovered and immediately retransferred into the uterine cavity. Immediate retransfer is more convenient to the patients and reduces the laboratory workload without compromising the treatment outcome.
Nursing practice is undergoing changes that are both exciting and controversial. The UKCC Scope of Professional Practice has encouraged nurses to re-evaluate their practice and, as a result, nurses from various fields have expanded their roles to meet the changing needs of patients and the profession. Published evidence shows that nurses can be as effective as doctors within these expanded roles, but that there is a danger that gender issues will cloud the debate because of the assumption that all nurses are female and all doctors are male. This problem is especially evident when female nurses perform an extended role involving male patients, although female doctors are in a similar position and work with the same patients without undue comment. The roles of doctors and nurses should complement each other, and all practitioners should work for the benefit of patients in their care, rather than defending traditional roles and hierarchy. There is confusion surrounding accountability of nurses who work in an extended role between the medical and the nursing profession, and both the Royal College of Nursing and the British Medical Association need to clarify the situation. This article looks at the arguments for and against the extended role of the nurse specialist and discusses current opinions within the nursing and medical fields. The article also describes how nurses at Midland Fertility Services have successfully extended their role to encompass ultra-sound-guided oocyte retrieval and surgical sperm recovery.
Catheter contamination compromises the treatment outcome in IVF only when there is no associated retained embryo(s). As increased vigilance in searching for extruded embryos may not be practical, we suggest that cervical mucus should be routinely aspirated and ET performed as atraumatically as possible.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.