Effect of the afterloaded external guidance embryo transfer technique on pregnancy rates in single embryo transfer cycles

Abstract

Objective: To investigate effect of the afterloaded external guidance embryo transfer technique on pregnancy rates in single embryo transfer intracytoplasmic sperm injection (ICSI) cycles. Material and Methods:This retrospective study was performed at the Dr. Zekai Tahir Burak Women's Health Research and Education Hospital. Three hundred and thirteen women who underwent ICSI were included in the study. Subjects were categorized according to the embryo transfer technique; Group 1 (n: 232): easy transfer with a soft catheter, Group 2 (n: 45): after external guidance transfer, and Group 3 (n: 36): difficult transfer with a stylet. Basal parameters, clinical and laboratory IVF outcomes and pregnancy rates were studied.Results: Infertility etiology, basal follicle stimulating hormone (FSH) levels, antral follicle count, duration of stimulation, total dose of gonadotropin, peak estradiol levels, endometrial thickness, oocyte number, 2 PN, and fertilization rate were similar between the three groups (p>0.05). Despite the decreased pregnancy rate in Group 3, there were no differences in clinical pregnancy rates among the groups (p=0.204). Conclusion:Embryo transfer is one of the critical steps in assisted reproduction procedures. Using the afterloaded external guidance embryo transfer technique did not improve pregnancy rates. (J Turkish-German Gynecol Assoc 2013; 14: 153-6) Key words: Embryo transfer technique, pregnancy rates, IVF Received: 27 June, 2013 Accepted: 19 July, 2013 Amaç: Dış kateter yönlendirmesi ile embriyo transferinin tek embriyo transferi yapılan intrasitoplazmik sperm injeksiyonu (ICSI) siklusların-da gebelik oranlarına etkisinin araştırılmasıdır.

The effect of embryo transfer technique on pregnancy rates in in vitro fertilization-intracytoplasmic sperm injection cycles: A prospective cohort study

“…Some existing studies have shown that the type of ET used can have as significant an effect on pregnancy rates in IVF-ICSI cycles as clinical and embryologic features, but different results have been reported ( 5 , 6 , 7 , 8 , 9 , 10 ) . In particular, Yılmaz et al ( 5 ) retrospectively compared the effects of undergoing easy, moderate, or difficult ET on CPR in 313 IVF-ICSI cycles and found that difficult ET was associated with lower CPR but with no statistically significant difference. Elsewhere, Burke et al ( 14 ) compared 159 cases of fresh ET with 46 frozen ETs and found that the technique and type of catheter used did not affect CPR.…”

“…Despite all the developments in assisted reproductive technology (ART) since the first live birth following in vitro fertilization (IVF) in 1978, pregnancy rates have remained at around 35-45% ( 1 , 2 , 3 , 4 ) . In ART cycles, the method of embryo transfer (ET) is important to clinical pregnancy success in addition to features such as age, the endometrial receptivity of the infertile woman, and embryo quality ( 5 , 6 , 7 , 8 ) . It has been claimed that faulty ET is responsible for 25-30% of failed implantations, relating either to the catheter application technique or the experience of the physician performing the ET procedure ( 9 , 10 , 11 , 12 ) .…”

“…It has also been asserted that performing mock ET before IVF-intracytoplasmic sperm injection (ICSI) can improve the success of the real ET ( 9 ) , but studies have also shown that a mock procedure does not reflect all problems that may occur during the actual ET ( 5 , 9 ) . Consequently, afterloading ET with external guidance has been suggested to avoid problems that may be encountered ( 5 , 11 ) . In the afterloading technique, a catheter with an inner sheath is inserted into the external cervical os, passed through the cervical canal to exit the internal os, and then advanced to 10 mm of the uterine fundus by gentle movement and guided by ultrasonography (USG).…”

“…A second catheter with embryo-loaded inner sheath is inserted along the same pathway from the first retracted catheter and advanced to 10 mm of the uterine fundus, and the embryos are released into the endometrium ( 11 ) . The process is intended to minimize embryonic and endometrial trauma ( 5 ) .…”

Pregnancy Outcomes of Infertile Patients Presenting to Our Assisted Reproductive Technology Center

“…Surrogacy, oocyte or sperm donation, human cloning, and the commercial purchase and sale of human reproductive products are legally prohibited and restricted in Türkiye (8). Many factors can affect the success of ART, such as the age of the infertile couple, embryo quality, endometrial receptivity, and embryo transfer technique (9)(10)(11)(12). In this study, we aimed to evaluate the demographic and stimulation characteristics, treatment results, and pregnancy outcomes of infertile couples who applied to our assisted reproductive technology (ART) center between January 2012 and December 2017.…”