IVF outcome is optimized when embryos are replaced between 5 and 15 mm from the fundal endometrial surface: a prospective analysis on 1184 IVF cycles

Reproductive Biology and Endocrinology

Alberto Revelli¹  Chiara Benedetto¹  Gemma Basso¹  Teresa Lantieri¹  Gianluca Gennarelli¹  Paola Dalmasso²  Valentina Rovei¹ 

[1] Physiopatology of Reproduction and IVF Unit, Department of Surgical Sciences, University of Torino, Sant’Anna Hospital, Torino, Italy;Medical Statistics Unit, Department of Public Health and Paediatrics, University of Torino, Torino, Italy

关键词: Ongoing pregnancy rate;    Abortion rate;    Pregnancy rate;    Implantation rate;    US-guided embryo transfer;    Embryo transfer;   

Others  :  809789
DOI  :  10.1186/1477-7827-11-114

 received in 2013-09-02, accepted in 2013-12-02,  发布年份 2013

【 摘 要 】

Background

Some data suggest that the results of human in vitro fertilization (IVF) may be affected by the site of the uterine cavity where embryos are released. It is not yet clear if there is an optimal range of embryo-fundus distance (EFD) within which embryos should be transferred to optimize IVF outcome.

Methods

The present study included 1184 patients undergoing a blind, clinical-touch ET of 1–2 fresh embryos loaded in a soft catheter with a low amount of culture medium. We measured the EFD using transvaginal US performed immediately after ET, with the aim to assess (a) if EFD affects pregnancy and implantation rates, and (b) if an optimal EFD range can be identified.

Results

Despite comparable patients’ clinical characteristics, embryo morphological quality, and endometrial thickness, an EFD between 5 and 15 mm allowed to obtain significantly higher pregnancy and implantation rates than an EFD above 15 mm. The abortion rate was much higher (although not significantly) when EFD was below 5 mm than when it was between 5 and 15 mm. Combined together, these results produced an overall higher ongoing pregnancy rate in the group of patients whose embryos were released between 5 and 15 mm from the fundal endometrial surface.

Conclusions

The site at which embryos are released affects IVF outcome and an optimal EFD range exists; this observations suggest that US-guided ET could be advantageous vs. clinical-touch ET, as it allows to be more accurate in releasing embryos within the optimal EFD range.

【 授权许可】

   
2013 Rovei et al.; licensee BioMed Central Ltd.

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