Objective: To compare pregnancy rates (PRs) after ultrasound-guided embryo transfer and embryo transfer based on ultrasonographic length measurement. Design: Prospective intervention group combined with retrospective control group Setting: University fertility clinic. Patient(s): Patients undergoing IVF and intracytoplasmic sperm injection.. Intervention(S): Transabdominal ultrasonographic guidance at embryo transfer. Main Outcome Measure(s): Pregnancy and implantation rates. Result(s): In 367 ultrasound-guided embryo transfers clinical PR, ongoing PR, and implantation rate were 35.1%, 31.1%, and 24.3%, respectively. In 363 embryo transfers based on previous ultrasonographic length measurement. the rates were 33.9%, 29.5%, and 24.2%, respectively. There were no statistical significant differences between the groups. Conclusion(s): Ultrasonographic guidance does not show any benefit in terms of PR and implantation rate compared to previous ultrasonographic length measurement, an other precise and traumatic transfer technique.