Effects of embryo transfer quality on pregnancy and live birth delivery rates

Spitzer, D; Haidbauer, R.; Corn, C.; Stadler, J.; Wirleitner, Barbara; Zech, Nicolas H.

doi:10.1007/s10815-011-9680-z

Cited by 30 publications

(12 citation statements)

References 18 publications

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“…The observation that presence of blood on the catheter is associated with poor outcome has been also showed by numerable previous studies (2,7,8,14,15,16) . More specifically, the presence of blood on the tip of the catheter, rather than on the outer sheath was shown to be associated with poor outcome (8) .…”

Section: Discussionsupporting

confidence: 52%

Pregnancy Outcome after Difficult Embryo Transfer in IVF-ET Cycles

Mahmod

Fayed²,

El-Din³

et al. 2018

Egyptian Journal of Hospital Medicine

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Background: Embryo transfer (ET) is one of the most crucial steps in IVF/ICSI treatment. Although it, apparently, seems simple, it is an integral part of IVF/ICSI and can affect the outcome of the whole treatment cycle. The majority of couples (approximately 80%) who undergo IVF reach the ET stage, yet few pregnancies occur. The pregnancy rate after ET is dependent on multiple factors including embryo quality, endometrial receptivity, and the technique of the ET. Aim of the Work: The aim of the current study is to investigate the clinical and ongoing clinical pregnancy rates in women who experience difficult embryo transfer (ET) after IVF/ICSI cycle. Patients and Methods: This prospective cohort study was conducted at Dar Al-Teb Infertility and IVF Center between January 2017 and January 2018. The study included 417 women planned to undergo ET. Results: The biochemical, clinical and ongoing clinical pregnancy rates were significantly lower in women who had difficult ET when compared to women who had easy ET [ORs 0.5, 95% CI (0.31 to 0.83); 0.48, 95% CI (0.29 to 0.79); 0.36, 95% CI (0.21 to 0.62); respectively]. Conclusion: Difficult ET is associated with significantly reduced biochemical, clinical and ongoing clinical pregnancy rates. Recommendations: ET should be smooth with easy passage of the transfer catheter. Since any uterine manipulation during ET adversely affects IVF results, therefore precaution should be taken to identify possibly difficult ET cases in advance.

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Section: Discussionsupporting

confidence: 52%

Pregnancy Outcome after Difficult Embryo Transfer in IVF-ET Cycles

Mahmod

Fayed²,

El-Din³

et al. 2018

Egyptian Journal of Hospital Medicine

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“…Therefore, either 40 μl hCG dissolved in embryo culture medium or 40 μl plain culture medium was applied to the surface of the endometrium using a Wallace embryo replacement catheter (Smiths Medical Inaternation, Kent, UK) 0.5 cm below the uterine fundus. Transfer of blastocysts was performed as described previously [ 26 ]. No statistically significant differences in patient characteristics between hCG and control groups were observed (Table 2 ).…”

Section: Methodsmentioning

confidence: 99%

Intrauterine administration of human chorionic gonadotropin does not improve pregnancy and life birth rates independently of blastocyst quality: a randomised prospective study

Wirleitner

Schuff

Vanderzwalmen

et al. 2015

Reprod Biol Endocrinol

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BackgroundSuccessful embryo implantation depends on a well-timed maternal-embryonic crosstalk. Human chorionic gonadotropin (hCG) secreted by the embryo is known to play a key role in this process and to trigger a complex signal transduction cascade allowing the apposition, attachment, and invasion of the embryo into the decidualized uterus. Production of hCG was reported to be dependent on blastocyst quality and several articles suggested that intrauterine hCG injection increases pregnancy and implantation rates in IVF patients. However, no study has as yet analysed birth rates as final outcome. Our objective was to determine whether clinical outcome after blastocyst transfer can be improved by intrauterine injection of hCG and whether this is dependent on blastocyst quality.MethodsA prospective randomised study was conducted in two settings. In cohort A, hCG application was performed two days before blastocyst transfer. In cohort B, the administration of hCG occurred just prior to embryo transfer on day 5. For both cohorts, patients were randomised to either intrauterine hCG application or to the control group that received culture medium. Clinical outcome was analysed according to blastocyst quality of transferred embryos.ResultsThe outcome of 182 IVF-cycles (cohort A) and 1004 IVF-cycles (cohort B) was analysed. All patients received a fresh autologous blastocyst transfer on day five. Primary outcomes were pregnancy rates (PR), clinical pregnancy rates (cPR), miscarriage rates (MR), and live birth rates (LBR). No improvement of clinical outcome after intrauterine hCG administration on day 3 (cohort A) or day 5 (cohort B) was found, independently of blastocyst quality transferred. The final outcome in cohort A: LBR after transfer of top blastocysts was 50.0 % with hCG and 53.3 % in the control group. With non-top blastocysts, LBR of 17.1 % (hCG) and 18.2 % (control) were observed (n.s.). In cohort B, LBR with top blastocysts was 53.3 % (hCG) and 48.4 % (control), with non-top blastocysts it came to 28.7 % (hCG) and 35.0 % (control). The differences between the groups were statistically not significant. Furthermore, we investigated a possible benefit of hCG administration in correlation with female age. In both age groups (<38 years and ≥ 38 years) we found similar LBR after treatment with hCG vs. medium. A LBR of 47.1 % vs. 48.7 % was obtained in the younger group and 26.6 % vs. 30.8 % in the older group.ConclusionsIn contrast to previous studies indicating a substantial benefit from intrauterine hCG application in cleavage stage embryo transfers, in our study we could not find any evidence for improvement of clinical outcome in blastocyst transfer cycles, neither with top nor with non-top quality morphology.

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“…• Degree of difficulty of the procedure (Lesny et al, 1998;Sallam & Sadek, 2003;Spitzer et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

“…Some authors have reported better pregnancy rates when using more flexible catheters, despite an association with increased ET procedure difficulty (Abou-Setta et al, 2005;Kably Ambe et al, 2011;Mansour et al, 1990;Saldeen et al, 2008;Spitzer et al, 2012;Wood et al, 1985). We have been using semi-rigid Frydman® Classic 4.5 catheters (CCD Laboratoire, Paris, France) for over ten years in our ET procedures.…”

Section: Introductionmentioning

confidence: 99%

Embryo Transfer Catheters: Softer is Easier

Ruhlmann

Gnocchi

Cattaneo

et al. 2015

JBRA Assisted Reproduction

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Objective: This study aimed to compare the use of semi-rigid and flexible catheters in terms of pregnancy rate and level of difficulty of the embryo transfer (ET) procedure. Methods: Seven hundred and thirty-nine consecutive follicular aspirations for IVF or ICSI performed in our private fertility clinic within a 30-month period were randomly divided into two groups. Patients were allocated to either of the groups at the time of follicular retrieval with the aid of a random number generator according to the catheter used in ET: Group 1 (n = 370) -Frydman Classic Catheter 4.5 catheters; and Group 2 (n = 369) -Frydman Ultrasoft 4.5 catheters. Only patients offered ET in the randomized cycle were included (Group 1 = 363 and Group 2 = 340). Patients did not change groups after catheter allocation. Statistical analysis was carried out using an unpaired t-test or a chi square test as appropriate. Differences with P<0.05 were considered. Results: A statistically significant difference in favor of the use of the Ultrasoft catheter was evident for parameters use of a tenaculum (19.8% vs. 5.9%) or a hysterometer (5.0% vs. 1.2%), presence of blood during post-ET inspection of the catheter (9.9% vs. 3.8%), and implantation rate (13.0% vs. 16.4%). Clinical pregnancy and delivery rates were comparable in both groups. Conclusions: Our results suggest that a softer catheter may help with difficult ETs. Softer catheters, as also reported by other authors, resulted in better implantation rates.

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Effects of embryo transfer quality on pregnancy and live birth delivery rates

Cited by 30 publications

References 18 publications

Pregnancy Outcome after Difficult Embryo Transfer in IVF-ET Cycles

Pregnancy Outcome after Difficult Embryo Transfer in IVF-ET Cycles

Intrauterine administration of human chorionic gonadotropin does not improve pregnancy and life birth rates independently of blastocyst quality: a randomised prospective study

Embryo Transfer Catheters: Softer is Easier

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