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

Research

Paola Dalmasso¹  Gemma Basso²  Gianluca Gennarelli²  Teresa Lantieri²  Chiara Benedetto²  Alberto Revelli²  Valentina Rovei² 

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

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

DOI  :  10.1186/1477-7827-11-114

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

来源: Springer

【 摘 要 】

BackgroundSome 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.MethodsThe 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.ResultsDespite 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.ConclusionsThe 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】

Unknown   
© Rovei et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.