Human Reproduction, Vol 12, 963-966, Copyright © 1997 by Oxford University Press
R Woolcott and J Stanger
Transvaginal ultrasound-guided embryo transfer was performed on 121
consecutive patients. Observation was made of guiding cannula and transfer
catheter placement in relation to the endometrial surface and uterine
fundus during embryo transfer. The position and movement of a
transfer-associated air bubble and the impact of subendometrial myometrial
contraction leading to endometrial movement was observed. Results indicate
that tactile assessment of embryo transfer catheter placement is
unreliable: in 17.4% of transfers the outer guiding catheter inadvertently
abutted the fundal endometrium. The outer guiding cannula indented the
endometrium in 24.8% and the transfer catheter embedded in the endometrium
in 33.1%. Unavoidable sub- endometrial transfers occurred in 22.3% of
transfers. Ultrasound-guided transfer avoided accidental tubal transfer in
7.4% of transfers. Transfer catheter withdrawal did not significantly
affect embryo transfer-associated air bubble position. Endometrial movement
due to sub-endometrial myometrial contraction was obvious in 36.4% of
cases, with active motion of the transfer-associated air bubble occurring
in 28.1%. Pregnancies occurred in 45.5% of transfers with endometrial
movement compared to 15.6% (P < 0.001) without.
ARTICLES
Potentially important variables identified by transvaginal ultrasound- guided embryo transfer
Lingard Fertility Centre, Newcastle, NSW, Australia.
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