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Mizrachi Y, McQueen DB. Embryo transfer success: It is in our hands. Fertil Steril 2022; 118:815-819. [PMID: 36192230 DOI: 10.1016/j.fertnstert.2022.08.858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/26/2022] [Accepted: 08/30/2022] [Indexed: 01/13/2023]
Abstract
Embryo transfer (ET) is considered as a critical step in the process of in vitro fertilization. Interestingly, studies have consistently shown significant outcome differences between physicians. Although the outcome of ET is not related to the physician's experience and specifically not different between fellows and attending physicians, certain techniques have been found to affect the success rate. This review summarizes the existing evidence regarding the impact of the individual physician performing ET and the techniques used.
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Affiliation(s)
- Yossi Mizrachi
- Reproductive Services Unit, The Royal Women's Hospital, and University of Melbourne, Victoria, Australia
| | - Dana B McQueen
- Reproductive Medicine Associates, San Francisco, California.
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D’Angelo A, Panayotidis C, Alteri A, Mcheik S, Veleva Z. Evidence and consensus on technical aspects of embryo transfer. Hum Reprod Open 2022; 2022:hoac038. [PMID: 36196080 PMCID: PMC9522404 DOI: 10.1093/hropen/hoac038] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 08/18/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
Ultrasound-guided embryo transfer (US-GET) is a widely performed procedure, but standards for the best practice are not available.
OBJECTIVE AND RATIONALE
This document aims to provide an overview of technical aspects of US-GET after considering the published data and including the preparation for the embryo transfer (ET) procedure, the actual procedure, the post-procedure care, associated pathologies, complications and risks, quality assurance and practitioners’ performance.
SEARCH METHODS
A literature search for evidence on key aspects of the ET procedure was carried out from database inception to November 2021. Selected papers (n = 359) relevant to the topic were analysed by the authors. The following key points were considered in the papers: whether ultrasound (US) practice standards were explained, to what extent the ET technique was described and whether complications or incidents and how to prevent such events were reported. In the end, 89 papers could be used to support the recommendations in this document, which focused on transabdominal US-GET.
OUTCOMES
The relevant papers found in the literature search were included in the current document and described according to the topic in three main sections: requirements and preparations prior to ET, the ET procedure, and training and competence for ET. Recommendations are provided on preparations prior to ET, equipment and materials, ET technique, possible risks and complications, training and competence. Specific aspects of the laboratory procedures are covered, in particular the different loading techniques and their potential impact on the final outcomes. Potential future developments and research priorities regarding the ET technique are also outlined.
LIMITATIONS, REASONS FOR CAUTION
Many topics were not covered in the literature review and some recommendations were based on expert opinions and are not necessarily evidence based.
WIDER IMPLICATIONS
ET is the last procedural step in an ART treatment and is a crucial step toward achieving a pregnancy and live birth. The current paper set out to bring together the recent developments considering all aspects of ET, especially emphasizing US quality imaging. There are still many questions needing answers, and these can be subject of future research.
STUDY FUNDING/COMPETING INTEREST(S)
No funding. ADA has received royalties from CRC Press and personal honorarium from Cook, Ferring and Cooper Surgical. The other co-authors have no conflicts of interest to declare that are relevant to the content of this article.
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Affiliation(s)
- Arianna D’Angelo
- Wales Fertility Institute, Swansea Bay Health Board, University Hospital of Wales, Cardiff University , Cardiff, UK
| | - Costas Panayotidis
- Attiki Iatriki advanced gynaecological ultrasound and hysteroscopic centre private practice , Pallini, Athens, Greece
| | | | - Saria Mcheik
- European society of human reproduction and embryology (ESHRE) Central Office , Strombeek-Bever, Belgium
| | - Zdravka Veleva
- Helsinki University Central Hospital , Helsinki, Finland
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Performing the embryo transfer: a guideline. Fertil Steril 2017; 107:882-896. [DOI: 10.1016/j.fertnstert.2017.01.025] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 01/27/2017] [Indexed: 11/17/2022]
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Schoolcraft WB. Importance of embryo transfer technique in maximizing assisted reproductive outcomes. Fertil Steril 2016; 105:855-60. [DOI: 10.1016/j.fertnstert.2016.02.022] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 02/08/2016] [Accepted: 02/12/2016] [Indexed: 11/26/2022]
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Sher G, Keskintepe L, Keskintepe M, Maassarani G, Tortoriello D, Brody S. Genetic analysis of human embryos by metaphase comparative genomic hybridization (mCGH) improves efficiency of IVF by increasing embryo implantation rate and reducing multiple pregnancies and spontaneous miscarriages. Fertil Steril 2009; 92:1886-94. [DOI: 10.1016/j.fertnstert.2008.11.029] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2008] [Revised: 11/06/2008] [Accepted: 11/21/2008] [Indexed: 02/06/2023]
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