Ultrasonographic Evidence that Bedrest after Embryo Transfer Is Useless

Lambers, M.J.; Lambalk, Cornelis B.; Schats, R.; Hompes, Peter G.A.

doi:10.1159/000226283

Cited by 21 publications

(10 citation statements)

References 23 publications

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“…Of all embryo(s) that implant successfully, 81% does so in the area where the air bubbles were initially seen on embryo transfer [28]. It is demonstrated that the air bubbles did not move after immediate ambulation after transfer in 94.1% of the cases [37] and this is confirmed by our study group [38]. We agree there is a lack of knowledge about positioning of the embryo(s) during and after embryo transfer in the uterine cavity, independently using a simple syringe or a new device.…”

Section: Discussionsupporting

confidence: 70%

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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Section: Discussionsupporting

confidence: 70%

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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“…This perspective was more common among less educated patients such that this finding may be explained by the association between less education and an increased likelihood of considering any lifestyle choice impactful. Notwithstanding, both findings demonstrate that despite insufficient evidence to support its use [6,7,12], bed rest remains a topic of concern for many IVF patients.…”

Section: Discussionmentioning

confidence: 93%

“…Studies suggest certain lifestyle behaviors and patient characteristics such as being underweight or obese adversely affect cycle success [2,3], while stress-reducing behaviors are generally thought to be beneficial [4,5]. Meanwhile, some popularly supported behaviors, such as complete bed rest after embryo transfer, have not been shown to improve outcomes [6,7].…”

Section: Introductionmentioning

confidence: 99%

Perceptions among infertile couples of lifestyle behaviors and in vitro fertilization (IVF) success

Hawkins

Rossi

Correia

et al. 2014

J Assist Reprod Genet

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Purpose To assess how patients perceive various lifestyle behaviors impact IVF success. Methods Cross-sectional study of heterosexual, Englishspeaking couples (n=138) who completed web-based surveys during IVF treatment cycle. Perceived impact of lifestyle choices assessed by multivariable logistic regression and pvalue tests for linear trend (P t ). Result(s) During the IVF cycle, most patients consider it helpful for women to exercise (76 %), avoid stress (87 %) and limit activity after embryo transfer (92 %). The majority of patients (62 %) consider rigorous exercise (4+ h/week) helpful and nearly one-third (32 %) perceive benefit to complete bed rest after transfer. Overall, couples with a sexspecific infertility diagnosis are more likely to consider partner's lifestyle choices impactful: male-factor couples are more likely to consider it helpful for men to limit cellular phone use (OR:2.73,CI:1.06-7.04) and diminished ovarian reserve couples are more likely to consider it helpful for women to limit exposure to plastics (OR:2.38,CI:1.03-5.51). Patients at higher levels of education (P t <0.01) and income (P t <0.01) are less likely to consider lifestyle impactful. Conclusion(s) Patient perceptions of the impact of lifestyle factors on IVF success vary by sex, infertility diagnosis and socioeconomic factors. Despite counseling to the contrary, many patients perceive benefit to rigorous exercise during the IVF cycle and complete bedrest following transfer. Results provide insight into patient beliefs and highlight opportunities to improve patient education, alleviate patient anxieties and potentially improve IVF outcomes.

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“…After transfer of fertilized embryos into the uterus via a small catheter, patients are often told to remain in the supine position for 30 minutes and minimize activity for the remainder of the day. Two prospective RCTs have assessed the benefit of bed rest after embryo transfer; no difference in uterine contents directly after transfer42 or clinical and ongoing pregnancy rates43 were evident between the 2 study groups of bed rest and immediate ambulation. A Cochrane review in 2009 further reported insufficient evidence in the literature to support the recommendation of bed rest after embryo transfer for in vitro fertilization 44…”

Section: Clinical Conditions For Which Bed Rest Is Prescribedmentioning

confidence: 99%

Bed Rest in Pregnancy

Bigelow

Stone

2011

Mount Sinai J Medicine

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The use of bed rest in medicine dates back to Hippocrates, who first recommended bed rest as a restorative measure for pain. With the formalization of prenatal care in the early 1900s, maternal bed rest became a standard of care, especially toward the end of pregnancy. Antepartum bed rest is a common obstetric management tool, with up to 95% of obstetricians utilizing maternal activity restriction in some way in their practice. Bed rest is prescribed for a variety of complications of pregnancy, from threatened abortion and multiple gestations to preeclampsia and preterm labor. Although the use of bed rest is pervasive, there is a paucity of data to support its use. Additionally, many well-documented adverse physical, psychological, familial, societal, and financial effects have been discussed in the literature. There have been no complications of pregnancy for which the literature consistently demonstrates a benefit to antepartum bed rest. Given the well-documented adverse effects of bed rest, disruption of social relationships, and financial implications of this intervention, there is a real need for scientific investigation to establish whether this is an appropriate therapeutic modality. Well-designed randomized, controlled trials of bed rest versus normal activity for various complications of pregnancy are required to lay this debate to rest once and for all.

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Ultrasonographic Evidence that Bedrest after Embryo Transfer Is Useless

Cited by 21 publications

References 23 publications

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

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

Perceptions among infertile couples of lifestyle behaviors and in vitro fertilization (IVF) success

Bed Rest in Pregnancy

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