A prospective, randomized study of ultrasound-guided embryo transfer

Interim analysis of a randomized clinical trial comparing abdominal versus transvaginal ultrasound‐guided embryo transfer

“…More recent studies have specifically addressed the technique of ET as being critical for optimizing outcome success including factors such as the technique, the type of catheter, and the use of ultrasound (US) guidance 2–5 . The application of ultrasound guidance (2‐D transabdominal, as well as 3‐D and 4‐D ultrasound‐guided) to ET 6 has been described in more than 150 clinical trials including 20 randomized clinical trials 7–26 and four meta‐analyses including a Cochrane review 4,5,27,28 . These studies suggest that ultrasound‐guided ET provides a benefit with respect to increases in clinical pregnancy and implantation rates compared to a blind, clinical touch method and is a critical factor in optimizing pregnancy outcomes.…”

Ultrasound guidance during embryo transfer: a systematic review and meta‐analysis of randomized controlled trials

“…However one study (from one record) comparing US guidance with clinical touch was not subsequently included in the quantitative meta‐analysis because there were insufficient data available. Included were: 12 studies (from 14 records) comparing US guidance with clinical touch using the same type of catheter; four studies (from seven records) comparing US guidance with clinical touch using different types of catheter; one study (from one record) comparing US guidance with clinical touch that had participants in the non‐US group using either the same or different types of catheter and that was therefore included in both subgroups; one study (from three records) comparing transvaginal US with transabdominal US using similar catheter type; two studies (from four records) comparing transvaginal US with transabdominal US using different catheter types; and one study (from one record) comparing hysterosonometry before ET with transabdominal US during ET using the same catheter.…”

“…However, using different types of catheter between the study arms was considered to be an important source of performance and detection bias in six studies. Nine studies were considered to be at unclear risk of attrition bias because we were not able to identify whether all randomized women were included in the analysis. The other studies were considered to be at a low risk.…”

“…All included studies were judged to be at low risk of selective reporting bias. Seven studies were judged to be at high risk of bias; six because they were published only as abstracts and there was insufficient information to properly examine the risk of bias; and two studies were considered to be at high risk of bias because they included only women with a reduced chance of having a difficult ET.…”

Ultrasound guidance for embryo transfer: where do we stand?

“…It is interesting to examine the evidence from the study of Revelli et al alongside that from other randomized controlled trials comparing different ultrasound techniques for assisting embryo transfer. Considering only studies that reported ongoing pregnancy, we identified 13 studies comparing TA‐UGET with ‘clinical touch’, three studies comparing TV‐UGET with TA‐UGET and only the present study comparing ULMbET with TA‐UGET, and compared them in a forest plot (Figure ). As a result, we are confident that TA‐UGET improves pregnancy rate compared with ‘clinical touch’ and that similar results might be obtained by using either TV‐UGET or ULMbET.…”