Optimizing the technique of embryo transfer

Mains, Lindsay; Voorhis, Bradley J. Van

doi:10.1016/j.fertnstert.2010.03.030

Cited by 135 publications

(103 citation statements)

References 91 publications

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“…The study also suggests that methodologies aimed at preventing the use of stylets, including trial transfers and cervical dilatation, should be considered. Our results are is in line with the well supported concept that difficult ETs result in reduced chances of successful implantation [1,3]. Determinants of reduced chances of implantation during difficult or traumatic ETs have not completely understood.…”

Section: Discussionsupporting

confidence: 90%

“…There is evidence suggesting that measures aimed at avoiding "difficult" transfers, including the use of soft catheters and ultrasound guidance, are important determinants for successful ET [1]. As a supportive example for this assertion, a study examining the outcome of 4,807 ETs found that easy or intermediate transfers yielded a 1.7 higher pregnancy rate in comparison to difficult transfers [2].…”

Section: Introductionmentioning

confidence: 99%

“…One of the most problematic step in the ET procedure is represented by the insertion of the catheter trough the internal cervical os [1,3]. Approaches used to overcome this problem and to facilitate ET include the use of firmer catheters or stylets [1,3].…”

Section: Introductionmentioning

confidence: 99%

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Assisted reproduction outcomes after embryo transfers requiring a malleable stylet

Tiboni¹,

Colangelo²,

Leonzio³

et al. 2012

J Assist Reprod Genet

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Objective This retrospective case-control study was undertaken to assess the impact of a malleable stylet application on embryo transfer (ET) outcome. Methods The Wallace malleable stylet was used when the soft inner catheter could not negotiate the internal os during ultrasound-guided ET. Patients having an age ≤37 years, with three embryos replaced were included in the analysis. Implantation rate, clinical pregnancy rate and live birth rate were the main outcome measures. Results The Wallace malleable stylet was applied in 164 (29.6%) of the 553 ETs evaluated. Implantation rate, clinical pregnancy rate and live birth rate showed a 5.6% (19.4% vs. 13.8%), a 10.8% (41.9% vs. 31.1%) and a 9.9% (37.3% vs. 27.4%) absolute difference, respectively, in favor of ETs not requiring the stylet. These differences were statistically significant (P<0.05). Conclusions ETs requiring stylet are associated with lower implantation, clinical pregnancy and live birth rates.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Assisted reproduction outcomes after embryo transfers requiring a malleable stylet

Tiboni¹,

Colangelo²,

Leonzio³

et al. 2012

J Assist Reprod Genet

View full text Add to dashboard Cite

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“…EBG recommendations include avoiding difficult ETs and the use of soft catheters [2]. Our data clearly show that the highest chance of pregnancy and live birth is with an atraumatic ET.…”

Section: Discussionmentioning

confidence: 63%

“…Cohen holds a "bad" ET responsible for a failed implantation in 30% of cases [1]. The Evidence Based Guidelines (EBG) recommends avoiding a difficult ET [2]. Various techniques and supporting devices are used, such as a soft catheter (e.g.…”

Section: Introductionmentioning

confidence: 99%

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

Spitzer

Haidbauer

Corn

et al. 2011

J Assist Reprod Genet

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Background To analyze the effects of embryo transfer (ET) quality on clinical pregnancy (CPR) and live birth delivery rates (LBDR). Methods In a retrospective study at a single, private infertility center between November 2005 and December 2009 one thousand fifty-five day-3 and day-5 ETs following IVF/ICSI/IMSI were evaluated. We analyzed the impact of an atraumatic ET with a soft catheter (ET 1), after external guidance (ET 2), after probing of the cervix with a stylet (ET 3), or after grasping the portio vaginalis with a tenaculum (ET 4) on CPR and LBDR. Results The use of external guidance showed a significantly reduced LBDR as compared to an atraumatic ET (26.0% vs. 32.5%). The lowest CPR and LBDR were found in ET 4. The application of stylets in cases of difficult ETs was superior to the use of external guidance. No differences in miscarriages between ET 1-4 were noted. Conclusions Besides embryo culture and patient history, the quality of an ET might also have an important impact on pregnancy outcome. Techniques to ensure an atraumatic ET, such as mechanic uterine cavity length measurements, before starting treatment might help identify patients at risk for a difficult ET and lead to modified treatments, such as the primary use of a stylet. Limitation of study: retrospective analysis

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