Journal of Assisted Reproduction and Genetics

, Volume 29, Issue 2, pp 131–135

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

  • Dietmar Spitzer
  • R. Haidbauer
  • C. Corn
  • J. Stadler
  • B. Wirleitner
  • N. H. Zech
ASSISTED REPRODUCTION TECHNOLOGIES

Abstract

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

Keywords

Embryo transfer quality Embryo transfer technique Assisted reproduction Clinical pregnancy rates Live birth delivery rates 

References

  1. 1.
    Cohen J. Embryo replacement technology. San Francisco 31 Annual post graduate course. ASRM. 1989Google Scholar
  2. 2.
    Mains L, Van Voorhis BJ. Optimizing the technique of embryo transfer. Fertil Steril. 2010;94:785–90.PubMedCrossRefGoogle Scholar
  3. 3.
    Kovacs GT. What factors are important for successful embryo transfer after in-vitro fertilization? Hum Reprod. 1999;14:590–2.PubMedCrossRefGoogle Scholar
  4. 4.
    Lass A, Abusheikha N, Brinsden P. The effect of a difficult embryo transfer on the outcome of IVF. Hum Reprod. 1999;14:2417.CrossRefGoogle Scholar
  5. 5.
    Lesny P, Killick SR, Robinson J, Raven G, Maguisness SD. Junctional zone contractions and embryo transfer: is it safe to use a tenaculum? Hum Reprod. 1999;14:2367–70.PubMedCrossRefGoogle Scholar
  6. 6.
    Lesny P, Killick SR, Tetlow RL, Robinson J, Maguisness SD. Embryo transfer—can we learn anything new from the observation of junctional zone contractions? Hum Reprod. 1998;13:1540–6.PubMedCrossRefGoogle Scholar
  7. 7.
    Biervliet FP, Lesny P, Maguiness SD, Killick SR. Ultrasound-guided embryo transfer maximizes the IVF results on day 3 and day 4 embryo transfer but has no impact on day 5. Hum Reprod. 2002;17:1131–2.PubMedCrossRefGoogle Scholar
  8. 8.
    Fanchin R, Ayoubi J-M, Righini C, Olivennes F, Schönauer LM, Frydman R. Uterine contractility decreases at the time of blastocyst transfer. Hum Reprod. 2001;16:1115–9.PubMedCrossRefGoogle Scholar
  9. 9.
    Fanchin R, Righini C, Olivennes F, Taylor S, De Ziegler D, Frydman R. Uterine contractility decreases at the time of blastocyst transfer. Hum Reprod. 1998;13:1968–74.PubMedCrossRefGoogle Scholar
  10. 10.
    Gardner DK, Schoolcraft WB. In vitro culture of human blastocysts. In: Jansen R, Mortimer D, editors. Towards reproductive certainty: infertility and genetics beyond 1999. Carnforth: Parthenon Press; 1999. p. 378–88.Google Scholar
  11. 11.
    Puissant F, Van Rysselberge M, Barlow P, Deweze J, Leroy F. Embryo scoring as a prognostic tool in IVF treatment. Hum Reprod. 1987;2:705–8.PubMedGoogle Scholar
  12. 12.
    Zegers-Hochschild F, Adamson GD, de Mouzon J, Ishihara O, Mansour R, Nygren K, Sullivan E, van der Poel S, on behalf of ICMART and WHO. The International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) revised glossary on ART terminology, 2009†. Hum Reprod. 2009;11:2683–7.CrossRefGoogle Scholar
  13. 13.
    Spandorfer SD, Goldstein J, Navarro J, Veeck L, Davis OK, Rosenwaks Z. Difficult embryo transfer has a negative impact on the outcome of in vitro fertilization. Fertil Steril. 2003;79:654–5.PubMedCrossRefGoogle Scholar
  14. 14.
    Drakeley A, Jorgensen A, Sklavounos J, Aust T, Gazvani R, Williamson P, et al. A randomized controlled clinical trial of 2295 ultrasound-guided embryo transfers. Hum Reprod. 2008;23:1101–6.PubMedCrossRefGoogle Scholar
  15. 15.
    Tur-Kaspa I, Yuval Y, Bider D, Levron J, Shulman A, Dor J. Difficult or repeated sequential embryo transfer do not adversely affect in-vitro fertilization pregnancy rates or outcome. Hum Reprod. 1998;13:2452–5.PubMedCrossRefGoogle Scholar
  16. 16.
    Gardner DK, Schoolcraft WB, Wagley L, Schlenker T, Stevens J, Hesla J. A prospective randomized trial of blastocyst culture and transfer in in-vitro fertilization. Hum Reprod. 1998;12:3434–40.CrossRefGoogle Scholar
  17. 17.
    Papanikolaou E, Camus M, Kolibianakis M, Van Landuyt L, Van Steirteghem A, Devroey P. In vitro fertilization with single blastocyst-stage versus single cleavage-stage embryos. N Engl J Med. 2006;354:1139–46.PubMedCrossRefGoogle Scholar
  18. 18.
    Zech NH, Lejeune B, Puissant F, Vanderzwalmen S, Zech H, Vanderzwalmen P. Prospective evaluation of the optimal time for selecting a single embryo for transfer: day 3 versus day 5. Fertil Steril. 2007;88:244–6.PubMedCrossRefGoogle Scholar
  19. 19.
    Angelini A, Brusco GF, Barnocchi N, El-Danasouri I, Pacchiarotti A, Selman HA. Impact of physician performing embryo transfer on pregnancy rates in an assisted reproductive program. J Assist Reprod Genet. 2006;23:329–32.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Dietmar Spitzer
    • 1
  • R. Haidbauer
    • 1
  • C. Corn
    • 1
  • J. Stadler
    • 1
  • B. Wirleitner
    • 2
  • N. H. Zech
    • 2
    • 3
  1. 1.IVF Centers Prof. Zech—SalzburgSalzburgAustria
  2. 2.IVF Centers Prof. Zech—BregenzBregenzAustria
  3. 3.Department for Obstetrics and Gynecology, Unit of Gynecological Endocrinology and Reproductive MedicineUniversity of GrazGrazAustria

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