Although we observed a small improvement (∼5%) in live birth/ongoing pregnancy and clinical pregnancy rates (PRs), the evidence is of very low quality and the best interpretation is that we are still very uncertain about differences in this comparison. The clinical equipoise remains and more large well-conducted randomized controlled trials are needed. They should use the same incubators in both groups and the embryologists should be blinded at least when evaluating laboratory outcomes.

Objectives To compare the effects of dydrogesterone and progesterone for luteal-phase support (LPS) in women undergoing assisted reproductive techniques (ART). Methods

The available evidence suggests that, although Essure prior to ET in women with hydrosalpinx improves the chance of achieving a clinical pregnancy compared with no intervention, it is associated with a higher rate of miscarriage when compared with the other interventions. Although this evidence is based on observational studies, we believe that salpingectomy should be the first option for women who are eligible for videolaparoscopy. However, it is still premature to make recommendations for women who are not eligible for surgery, and randomized controlled trials are needed to clarify which is the best treatment alternative in such a scenario. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

Objective: The objective of the present study was to determine the influence of the embryo placement depth on the endometrial cavity in relation to the reproductive outcomes, after frozen-thawed embryo transfer performed under transabdominal ultrasound guidance. Methods: Retrospective cohort study that evaluated the influence of the embryo placement depth in the endometrial cavity in relation to the reproductive outcomes of patients submitted to cryotransfer cycles at a private assisted reproduction clinic, from 2012 to 2017. The patients were classified according to three variables: <10mm, 10 to 15mm and >15mm. The primary outcome was clinical pregnancy, and the secondary outcomes were miscarriage, ongoing pregnancy and live birth. The data was summarized as relative risk, with a 95%CI. Results: Clinical and ongoing pregnancy rates were higher in the 10-15mm and >15mm Groups, when compared to the <10mm Group; there was no statistical difference between the groups in terms of miscarriage and live birth rates. We performed a subsequent analysis, using the same sample of patients, comparing only the <10mm and ≥10mm variables. The ≥10mm Group had better reproductive outcomes, with higher clinical and ongoing pregnancy rates. Conclusion: Pregnancy rates are influenced by embryo transfer site, and better results can be achieved when the tip of the catheter is placed in the central area of the endometrial cavity, especially when the distance from the endometrial fundus is >10mm.

AGRADECIMENTOSAgradeço imensamente ao meu orientador, Prof. Wellington de Paula Martins, por ter acreditado em mim, me oferecendo tantas possibilidades. Obrigada por confiar no meu potencial muito mais do que eu mesma, e por compartilhar seu entusiasmo pela ciência. À Dra. Carolina Nastri, pela valiosa contribuição neste trabalho.Aos co-autores Prof. Paula Navarro e Prof. Rui Ferriani, grandes exemplos de profissionais, por me inspirarem a melhorar sempre.A toda a Equipe de Reprodução Humana do HC-FMRP, pelo acolhimento carinhoso e por terem contribuído de forma tão essencial para a minha formação profissional.Aos queridos amigos Beatrice, Lívia, Paula e Vinícius. Obrigada pela convivência, e por terem tornado o período em Ribeirão Preto mais leve e alegre.À querida amiga Natália, pela cumplicidade, compreensão, e por ter me encorajado a abrir novas portas no meu caminho.A todos meus familiares e amigos, pela torcida constante.Ao Marcelo, meu motivo diário de agradecimento, pelo amor, companheirismo, e apoio em todas as minhas decisões. Justificativa: Há evidências de que o uso de progesterona para suporte de fase lútea melhora os resultados reprodutivos em mulheres submetidas a técnicas de reprodução assistida (TRA).Há várias hipóteses para justificar a deficiência de fase lútea após a estimulação ovariana controlada (EOC) para TRA. Atualmente, acredita-se que os níveis supra-fisiológicos de esteroides alcançados durante a EOC persistem após a aspiração folicular, graças à formação de múltiplos corpos lúteos. Dessa forma, ocorre um feedback negativo prematuro na secreção de hormônio luteinizante (LH), causando um defeito da fase lútea e baixos níveis de progesterona. A progesterona natural por via intramuscular ou vaginal apresenta efeitos comparáveis sobre os parâmetros de gravidez clínica e gravidez em curso, embora as Background: There is evidence that using progesterone for LPS improves the reproductive outcomes in women undergoing ART. There are several hypotheses to justify the lutheal