The available evidence suggests that there is a benefit of using US guidance during ET. However, both US-guided transfer and clinical touch should be considered acceptable, as the benefit of US is not large and should be balanced against the increased cost and need to change the catheter type. More studies are required before conclusions can be drawn regarding the effect of other techniques on reproductive outcome.
Objective To evaluate the efficacy and safety of monitoring controlled ovarian stimulation (COS) using ultrasonography. (RR, 1.00; 95% CI, n = 72) and the number of oocytes retrieved (MD, 95% CI,
Methods We performed a search in April 2013 for randomized controlled trials (RCTs
Short oral presentation abstractswhen transferring embryos at blastocyst stage. More studies are still required to improve the quality of the current evidence and also to examine whether this intervention is useful when transferring embryos at cleavage-stage.OP33.05 Accuracy of early ultrasound in the diagnosis of ectopic pregnancy in the absence of an extrauterine embryo: a systematic review and meta-analysis Objectives: To evaluate, by systematic review of the literature, the accuracy of first trimester ultrasound in diagnosing an ectopic pregnancy (EP) in the absence of an extrauterine embryo. Methods: The systematic review was registered with PROSPERO and conducted following the PRISMA checklist. We searched MEDLINE, Embase and the Cochrane Library for citations. Primary studies reporting original data regarding the ultrasonographic diagnosis of an EP were selected in a two-stage process. Data were extracted by two reviewers. Accuracy measures including sensitivity, specificity and likelihood ratios were calculated for each test i.e. empty uterus (EU), adnexal mass (AM), free fluid (FF) and pseudosac (PS). Individual study estimates were plotted in summary ROC and forest plots for examination of heterogeneity. The quality of studies was assessed using the QUADAS-2 checklist. Results: 31 studies including 5858 women were selected from 13246 potential papers. Accuracy measures following meta-analysis are illustrated in table 1. Conclusions: In women in early pregnancy presenting with abdominal pain and vaginal bleeding the ultrasonographic finding of an EU is suggestive of an EP (positive post-test probability 71.4%)
Objectives: To evaluate the efficacy and safety of monitoring COS by ultrasound with or without hormonal levels, for women undergoing ART and to compare different ultrasound methods. Methods: Authors searched for randomized controlled trials (RCT) in April 2013. Only studies that compared different methods for monitoring COS -including ultrasound assessment of follicles (alone or combined with hormonal levels) in at least one group -were considered eligible. Results: The search retrieved 1515 records; six studies were eligible. Three studies were judged to be at high risk of bias. No studies reported live birth. Five studies compared US only vs. US + Hormones for cycle monitoring. For OHSS (OR 1.02, 95% CI 0.47 to 2.25), and miscarriage (RR 0.37, 95% CI 0.07 to 1.79, P = 0.21, 1 RCT), the confidence intervals were very wide and compatible with appreciable benefit, no effect or appreciable harm. For clinical pregnancy, the CI was wide and compatible with small benefit, no effect, or small harm (RR 0.95, 95% CI 0.78 to 1.16). For the number of oocytes retrieved, the CI was wide and compatible with appreciable benefit or no effect for US only compared with US + Hormones (MD 0.77 oocytes, 95% CI −0.42 to 1.96, P = 0.20). Only one study compared 3DUS vs. 2DUS: the CI was very wide and compatible with appreciable benefit, no effect or appreciable harm for 3DUS compared with 2DUS in regards to clinical pregnancy (RR = 1.00, 95% CI 0.58 to 1.73) and number of oocytes retrieved (MD −0.37 oocytes, 95% CI −3.63 to 2.89).
Conclusions:Monitoring COS with US only is unlikely to cause a relevant reduction the number of oocytes retrieved; as well as substantial changes in clinical pregnancy when compared with US + Hormones. However, we are still uncertain of the effect for other important outcomes. We are also uncertain about the effect of using 3DUS for monitoring COS. More studies evaluating the optimal monitoring for COS are still needed.OC09.05
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