Embryo transfer--can we learn anything new from the observation of junctional zone contractions?

Lesny, P.; Killick, S.R.; Tetlow, R.; Robinson, John K.; Maguiness, S.D.

doi:10.1093/humrep/13.6.1540

Cited by 190 publications

(109 citation statements)

References 29 publications

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“…These contractions seem to particularly occur after difficult ETs and might interfere with embryo implantation [5,6]. The impact of such contractions might even be more profound on day-3 as compared to day-5 ETs due to the influence of progesterone [7][8][9].…”

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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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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“…It is advantageous to place the embryos into the uterus in as atraumatic a manner as possible [1][2][3]. Uterine contractions [4,5], presence of blood on the catheter [6,7], bacterial contamination of the catheter [8], difficulty of transfer [9], and the type of catheter [10][11][12][13], all influence the success rate of the IVF/ICSI treatment. The embryos should be placed in an area within the uterus most likely to afford implantation.…”

Section: Introductionmentioning

confidence: 99%

The impact of the depth of embryo replacement on IVF outcome

Pacchiarotti

Mohamed

Micara

et al. 2007

J Assist Reprod Genet

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Purpose: To evaluate the effect of the depth of embryo transfer replacement on clinical pregnancy rate.Methods: Data from a total of 104 consecutive embryo transfers performed on 104 womenn aged 26-37 years were prospectively collected for this study. All patients underwent a standard down regulation protocol for ovarian stimulation. Oocytes retrieval were performed at 36 h after hCG administration. Embryo transfer took place at 48 h after insemination. The patients were matched in two groups according to the distance between the tip of the catheter and the uterine fundus at transfer (group A > 10 < 15 mm and group B ≤ 10 mm). The same method of loading embryos into the embryo transfer catheter was used.Results: Clinical pregnancy rates varied significantly (p ≤ 0.05) between the two groups: 27.7% in group A and 14% in group B. The number and quality of embryos transferred did not differ between the groups.Conclusions: The results suggest that the depth of embryo replacement may be an important variable in embryo transfer technique.

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“…The importance of this step has been emphasized by the fact that different providers at the same institution may have disparate pregnancy rates after ET (8,9). Other variables affecting pregnancy include the ease of ET (7,10,11), presence or absence of blood on the transfer catheter (12), type of catheter used (13), technique used to perform the transfer (14)(15)(16), and experience of the physician (17).…”

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confidence: 99%

Embryo afterloading: A refinement in embryo transfer technique that may increase clinical pregnancy

Neithardt

Segars

Hennessy

et al. 2005

Fertility and Sterility

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Objective-Given the importance of ET technique during assisted reproductive technology cycles, we evaluated the effect of embryo afterloading subsequent to placement of the ET catheter on pregnancy rates vs. a standard direct ET. Design-Retrospective cohort analysis. Setting-University-based assisted reproductive technology program.Patient(s)-Patients undergoing a fresh nondonor day 3 ET by a single provider over a 1-year period. Intervention(s)-None. Main Outcome Measure(s)-Clinical pregnancy.Result(s)-One hundred twenty-seven patients met inclusion criteria, and the overall pregnancy rate was 46.5%. There was no difference between the two groups with respect to age, basal FSH, or number of embryos transferred. The ET method used was at the discretion of the provider. There was no difference between the two groups in the presence of blood on the transfer catheter. However, there were significantly more transfer catheters with mucus contamination in the direct transfer group (25.58% vs. 5.95%). The clinical pregnancy rate in the group with ET using the afterloading technique was higher than in the direct ET group (52.4% vs. 34.9%). Conclusion(s)-There was a trend toward an increase in pregnancy rate when an embryo afterloading technique was used. A prospective randomized trial is needed to examine this issue. Technology reported an increase in live birth rates from 28% in 1996 to 32% in 2002 (1). This increase has been attributed to multiple factors including improved stimulation protocols (2-4), advances in embryology laboratory techniques (5), and improvement in ET techniques (6, 7). KeywordsEmbryo transfer is universally accepted as a crucial last step in any ART cycle. The importance of this step has been emphasized by the fact that different providers at the same institution may have disparate pregnancy rates after ET (8,9). Other variables affecting pregnancy include the ease of ET (7, 10, 11), presence or absence of blood on the transfer catheter (12), type of catheter used (13), technique used to perform the transfer (14-16), and experience of the physician (17).In the early 1990s, studies were first published on the use of a mock or "dummy" ET before the start of an IVF cycle (11,18). A mock ET allows the physician to choose the appropriate transfer catheter, measure the depth of the endometrial cavity, and anticipate potential problems at ET. However, a mock transfer remote from the actual ET is done under different circumstances and may not be reflective of actual conditions encountered on the day of ET. Sharif et al. (19) proposed to circumvent this problem by performing a mock ET immediately before the actual ET.To avoid additional trauma by the passage of two separate catheters, we began transferring embryos by an afterload technique, in which an empty catheter is placed at, or just past, the internal cervical os. The inner sheath is withdrawn, and a second inner sheath containing the embryos is passed. This gives the provider the benefit of an immediate mock transfer while minimizing mani...

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Embryo transfer--can we learn anything new from the observation of junctional zone contractions?

Cited by 190 publications

References 29 publications

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

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

The impact of the depth of embryo replacement on IVF outcome

Embryo afterloading: A refinement in embryo transfer technique that may increase clinical pregnancy

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