Transabdominal ultrasound-assisted embryo transfer and pregnancy outcome

Objective: To assess the clinical value of transabdominal ultrasound (TAS)-assisted embryo transfer oil outcomes of in vitro fertilization-embryo transfer (IVF-ET) in comparison to the "clinical touch" method of transcervical embryo transfer by one physician and to determine if transabdominal ultrasound Should be applied to all cases of embryo transfer in this practice. Design: A retrospective comparison study. Setting: A university-based IVF practice. Patient(s): Two hundred forty-nine patients who underwent transcervical transfer of fresh ernbryos created using autologous oocytes performed by the same physician from July 1, 2003, to June 30, 2004. Intervention(s): On selected days, at time of embryo transfer, transabdominal ultrasound was performed to guide catheter placement approximately 1 cm from the uterine fundus. Main Outcome Measure(s): The presence of at least one gestational sac on ultrasound was compared in the two study groups; additionally, the clinical pregnancy rate (presence of fetal cardiac activity observed on ultrasound), the ectopic pregnancy rate, the biochemical pregnancy rate. and the implantation rate (number of gestational sacs identified on ultrasound per number of embryos transfered) between groups was evaluated. Characteristics of the two cohorts were analyzed to verify similarities between the treatment and control groups, including age of recipient, prior IVF history, day of transfer (day 3 or day 5 after retrieval), difficulty of transfer. the use of a tenaculum, and the quality and number of embryos transfered.