The influence of the depth of embryo replacement into the uterine cavity on implantation rates after IVF: a controlled, ultrasound-guided study

Coroleu, Buenaventura; Barri, Pedro N.; Carreras, Olga; Martínez, Francisca; Parriego, M; Hereter, L.; Parera, Núria; Veiga, Anna; Balasch, Juan

doi:10.1093/humrep/17.2.341

Cited by 180 publications

(52 citation statements)

References 35 publications

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“…Some of these proposed factors include characteristics of the catheter [1], operator experience [2], the site of uterine cavity where the embryo is transferred [3-6], presence of mucus or blood on the catheter following withdrawal [7], uterine contractions secondary to uterine manipulations, and difficulty passing through the cervix [8, 9]. …”

Section: Introductionmentioning

confidence: 99%

Prospective Randomized Trial Comparing Embryo Transfers of Cases with and without Catheter Rotation during Its Withdrawal

Abide¹,

Özkaya²,

Sanverdi³

et al. 2018

Gynecol Obstet Invest

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Objective: To compare embryo transfer (ET) technique based on catheter rotation during its withdrawal in cases with unexplained infertility in a prospective, randomized trial (NCT03097042). Methods: Two hundred intracytoplasmic sperm injection (ICSI) patients undergoing ET with cleaving or blastocyst-stage fresh embryos were randomized into 2 groups: cases with (n = 100), and without (n = 100) catheter rotation during its withdrawal. Groups were matched for age and some clinical parameters. A soft catheter was used to transfer a single embryo with catheter rotation during its withdrawal in the study group and without rotation in the control. The use of a stiff catheter or tenaculum was not needed in any case. Groups were compared in terms of cycle characteristics and clinical pregnancy rates. Results: Pregnancy rate was significantly higher in the study group (41 vs. 26%, p = 0.04). Clinical pregnancy rate was also significantly higher in the study group (39 vs. 25%, OR 1.9 [1.1–3.5], p = 0.05). On the other hand, the ongoing pregnancy rate was similar between the 2 groups (33 vs. 23%, p = 0.2). Conclusion: Catheter rotation during its withdrawal may be associated with increased pregnancy and clinical pregnancy rates; however, the difference in ongoing pregnancy rates did not reach statistical significance.

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Section: Introductionmentioning

confidence: 99%

Prospective Randomized Trial Comparing Embryo Transfers of Cases with and without Catheter Rotation during Its Withdrawal

Abide¹,

Özkaya²,

Sanverdi³

et al. 2018

Gynecol Obstet Invest

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“…Along with these factors on treatment success, the site of embryo transfer has also been debated by several investigators but lacks a consensus (9)(10)(11)(12)(13). Several studies demonstrated a significant effect of embryo transfer depth on IVF and embryo transfer outcomes (9)(10)(11)(12).…”

mentioning

confidence: 99%

Impact of embryo replacement depth on in vitro fertilization and embryo transfer outcomes

Tıraş

Polat

Korucuoğlu

et al. 2010

Fertility and Sterility

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“…In early times, it was reported to position the embryo(s) 0.5 cm from the endometrial fundus [31,32,33]. In later years, studies conclude to position the embryo(s) 2 cm from the endometrial fundus [13,18,19]. Most recently, Cenksoy et al [17] reported that the optimal position of the air bubble seems to be a distance of <10 mm from the endometrial fundus, in accordance with Friedman et al [34].…”

Section: Discussionmentioning

confidence: 99%

“…Although about 85% of all couples undergoing IVF or ICSI treatment reach the stage of embryo transfer, only one-third actually becomes pregnant at the end of a treatment cycle (fresh cycles: most recent ESHRE European register: 2009 [4]). Various factors concerning embryo transfer have been described to explain those limited embryo implantation rates: the type of catheter used for the transfer [5,6,7]; including the relevance of a soft distal part on the catheter [8,9], the presence of blood or bacteria on the catheter [10,11]; the experience of the physician [12] and the use of ultrasound guidance [13,14,15,16]. Much of the inefficiency of the embryo implantation may therefore be derived from the embryo transfer technique [3].…”

Section: Introductionmentioning

confidence: 99%

“…Despite its relevance, the technique used in embryo transfer has received little attention and progress until recent years [2,3]. Several studies [13,17,18,19,20,21,22,23] have demonstrated that the depth of the embryo placement into the uterine cavity, as a result of the embryo transfer technique, should be considered an important factor concerning pregnancy rates. Our research group pointed out that despite standardization of the transfer by protocol, the final position of the transferred air bubbles including the embryo(s) was not accurately predictable because of dependency of the injection speed which depends on the force used to press the plunger, the resistance of the plunger and a possible uterine resistance during transfer [24].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Embryo Transfer with Controlled Injection Speed to Increase Pregnancy Rates: A Randomized Controlled Trial

Caanen

Houwen²,

Schats³

et al. 2016

Gynecol Obstet Invest

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Background/Aims: Catheter injection speed affects depth and placement of the embryo into the uterine cavity and is shown to be highly variable in, and between, subjects in a manually performed embryo transfer. In an effort to standardize the injection speed during embryo transfer, we developed an automated transfer pump: the pump-regulated embryo transfer (PRET) device. In this randomized controlled trial, we aimed to investigate if standardization of the injection speed and pressure with this PRET results in a better controlled positioning of the transferred embryo(s). Methods: Five hundred ninety-nine in-vitro fertilization/intracytoplasmic sperm injection/frozen-thawed embryo transfer cycles were randomly assigned to the PRET or manual transfer. Positioning of the embryo(s) into the uterine cavity was measured with ultrasound. Results: The PRET device generates a significantly smaller variance of the positioning of the embryo(s) into the uterine cavity. This resulted in an ongoing pregnancy rate of 21% in the PRET versus 17% in the manual (p = 0.22) transfer group; frozen-thawed embryo transfers resulted in 17.5 versus 10.9% (p = 0.097), respectively. Conclusion: The PRET results in better controlled positioning of the embryo(s), and it also gives the opportunity to standardize embryo transfer. Whether the PRET may positively influence pregnancy rates, needs to be investigated in a multicenter trial.

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The influence of the depth of embryo replacement into the uterine cavity on implantation rates after IVF: a controlled, ultrasound-guided study

Abstract: The depth of the embryo replacement into the uterine cavity may influence implantation rates, and thus it should be considered as an additional procedure among factors recently proposed as associated with successful embryo transfer after IVF.

Cited by 180 publications

References 35 publications

Prospective Randomized Trial Comparing Embryo Transfers of Cases with and without Catheter Rotation during Its Withdrawal

Prospective Randomized Trial Comparing Embryo Transfers of Cases with and without Catheter Rotation during Its Withdrawal

Impact of embryo replacement depth on in vitro fertilization and embryo transfer outcomes

Embryo Transfer with Controlled Injection Speed to Increase Pregnancy Rates: A Randomized Controlled Trial

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