Between October 1998 and January 1999, we examined the influence of ultrasound guidance in embryo transfer on pregnancy rate in 362 patients from our in-vitro fertilization (IVF)-embryo transfer programme. These patients were prospectively randomized into two groups: 182 had ultrasound-guided embryo replacement, and 180 had clinical touch embryo transfer. There were no statistically significant differences between the two groups with respect to age, cause of infertility and in the characteristics of the IVF cycle. The pregnancy rate was significantly higher among the ultrasound-guided embryo transfer group (50%) compared with the clinical touch group (33.7%) (P < 0.002). Furthermore, there was also a significant increase in the implantation rate: 25.3% in the ultrasound group compared with 18.1% in the clinical touch group (P < 0.05). In conclusion, ultrasound assistance in embryo transfer significantly improved pregnancy and implantation rates in IVF.
The depth of the embryo replacement into the uterine cavity may influence implantation rates, and thus it should be considered as an additional procedure among factors recently proposed as associated with successful embryo transfer after IVF.
This pilot study suggests that the use of the echogenic Wallace catheter simplifies ultrasound-guided embryo transfer but not definite benefit in terms of pregnancy rates was obtained. In contrast, the use of the new catheter was associated with a significant increase in the number of twin pregnancies.
It is essential to deposit embryos as gently as possible during IVF, avoiding manoeuvres that might trigger uterine contractions which could adversely affect the results of this treatment. The time during which the embryo transfer catheter remains in the cervical canal might be related to stimulation of contractions. This study investigates the influence that the time interval before withdrawal of the catheter after ultrasound (US)-guided embryo deposit might have on the pregnancy rate in patients under IVF cycles. A total of 100 women about to undergo transfer of at least two optimal embryos was studied. The women were prospectively randomized into two groups: (i) slow withdrawal of the catheter immediately after embryo deposit (n = 51); and (ii) a 30 s delay before catheter withdrawal (n = 49). The pregnancy rates for transfer in the two groups were 60.8 and 69.4% respectively, with no significant differences. There were no statistically significant differences in pregnancy rates between the two patient groups. The results indicate either that the waiting interval was insufficient to detect differences, or that the retention time before withdrawing the catheter is not a factor that influences pregnancy rate.
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