Abstract
ObjectivePregnancy after an embryo transfer depends largely on embryo quality, endometrial receptivity, and the technique used in the embryo transfer. Embryo transfers have been reported as inevitably traumatic and difficult for 5-7% of patients in assisted reproduction treatment. In these cases, transmyometrial embryo transfer should be considered as a suitable method to overcome difficult embryo transfers. The aim of this study was to report our experience with this technique and analyze its causes, results and complications.MethodsSince 1993, 39 women (40 cycles of assisted reproductive technology treatment) were submitted to transmyometrial embryo transfers in our center. The procedures were carried out as described by the Towako group.ResultsThe enrolled female patients had a mean age of 34 years and a mean baseline FSH level of 6.89 IU/mL. The median number of retrieved oocytes was 7.50 and a mean of 2.63 embryos were transferred. Implantation rate was 9.5%. With respect to clinical results, pregnancy and miscarriage rates were 25% and 30%, respectively. Since there were two twin pregnancies, the live birth rate was 22.5% (9/40). No major complications were reported.ConclusionTransmyometrial embryo transfer can and should be an option in cases of difficult/impossible transcervical embryo transfer.
Highlights
The technique of embryo transfer is crucial and requires great attention and careful thought.Pregnancy after an embryo transfer (ET) depends on a number of factors, including embryo quality, endometrial receptivity, and embryo transfer technique itself.Historically, embryo transfer methods have received little attention and minimal data has been published on the subject
One of the most challenging issues arising from ET involves the management of very difficult or impossible transcervical embryo transfer (TCET) procedures
It has been shown that the clinical pregnancy rate decreases progressively as additional maneuvers are performed during ET (Kava-Braverman et al, 2017)
Summary
The technique of embryo transfer is crucial and requires great attention and careful thought.Pregnancy after an embryo transfer (ET) depends on a number of factors, including embryo quality, endometrial receptivity, and embryo transfer technique itself.Historically, embryo transfer methods have received little attention and minimal data has been published on the subject. The technique of embryo transfer is crucial and requires great attention and careful thought. Pregnancy after an embryo transfer (ET) depends on a number of factors, including embryo quality, endometrial receptivity, and embryo transfer technique itself. Embryo transfer methods have received little attention and minimal data has been published on the subject. The reason for this is their apparent simplicity. Difficult transfer procedures occur frequently and have been shown to decrease pregnancy rates significantly. It has been reported that embryo transfer is inevitably traumatic and difficult to 5-7% of patients in assisted reproduction treatment (Tur-Kaspa et al, 1998; Wood et al, 1985). In about one percent of the cases the transcervical route may be nearly impossible to use, even by experienced practitioners, mainly due to anatomical and pathological cervical disorders such as congenital stenosis, atresia or previous trachelectomy (Healy et al, 2015; Wood et al, 1985)
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