Human Reproduction, Vol. 16, No. 9, 1904-1908,
September 2001
© 2001 European Society of Human Reproduction and Embryology
Ultrasound-guided embryo transfer maximizes the IVF results on day 3 and day 4 embryo transfer but has no impact on day 5
1 4th Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, Thessaloniki Greece, 2 Iakentro Fertility Center, Thessaloniki, Greece and 3 SIMAF, Van Helmont Hospital, Vilvoorde, Belgium
BACKGROUND: The use of ultrasound-guided embryo transfer has been reported to affect success rates in some centres but not others. In a prospective study, we examined the influence of ultrasound guidance in embryo transfer performed on different days after oocyte retrieval. METHODS: Two different methods of embryo transfer were evaluated in 1069 consecutive transfers. The ultrasound-guided embryo transfer was used in 433 cases, whereas 636 embryo transfers were performed with the tactile assessment (`clinical feel') method. RESULTS: Ultrasound-guided embryo transfer yielded a higher overall pregnancy rate than the `clinical feel' approach, 47 versus 36% (P < 0.001). This difference was statistically significant where embryos were transferred after 3 or 4 days of culture, 45.9 versus 37.1% (P = 0.001) and 42.3 versus 27% (P = 0.035) respectively but not significant (P = 0.112) on day 5 embryo transfer (56.3 versus 45.7%). Likewise, the implantation rate was significantly different between the two groups on day 3 and 4 embryo transfer, 23.3 versus 15.8% (P < 0.01) and 21.6 versus 15.7% (P < 0.05%) respectively but no statistical difference was noted on day 5 embryo transfer, 26.7 versus 23.6%. CONCLUSION: Ultrasound assistance in embryo transfer on day 3 and 4 significantly improved pregnancy rates in IVF but had no impact on day 5.
Key words: embryo transfer/ultrasound-guided embryo transfer/IVF/uterine receptivity/window of implantation
4 To whom correspondence should be addressed at Iakentro Fertility Center, Thessaloniki, Greece. E-mail: iakentro{at}otenet.gr
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