Flow Pattern of the Fluid During Embryo Transfer Determined With Transabdominal Ultrasound is a Predictive Factor in the Pregnancy Rate in IVF-ET Cycle

Abstract

Optimization of the embryo transfer technique to improve implantation rate is still a challenging subject in IVF cycle. Several approaches have been developed such as using ultrasound guidance during ET, performing a mock embryo transfer prior to the actual procedure, removing the cervical mucus and flushing the cervical canal with medium and using soft catheter. Although, ultrasound guidance offered some advantages such as visualization of the catheter tip and air bubble, and the measurement of the tip from the fundus. There is still debate about the role of the appaerance of the flow pattern and the appearance of the air bubble in IVF-ET cycle. Our aim was to evaluate the effect of the flow pattern of the fluid on the outcome of IVF cycle. Observational study A total of 246 embryo transfer procedures were evaluated. Only cycles with 3 good quality embryos transferred on day 3 were included. Tip of the catheter was located 2 cm below the uterine fundus. Abdominal sonogram was performed with the full bladder. The total amount of fluid loaded with the embryos was 40 μl. Air tight syringe was used to transfer the embryos. Fundal splash was observed in 214 embryo transfers (Group I) whereas in 32 transfers embryo associated air bubble moved backwards (Group II) following injection. Average age, duration of infertility, number of oocytes obtained were similar between two groups. Pregnancy rates were 52.3% (112/214) and 25% (8/32) (p<0.05) for Group I and Group II, respectively. Flow pattern of the medium during embryo transfer observed with abdominal sonogram is an important parameter on the success rate of embryo transfer. Clinical pregnancy rate is worse following embryo transfers in which fluid moved backwards in the endometrial cavity.