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Evaluation of a strategy for difficult embryo transfers from a prospective series of 2,046 transfers
OBJECTIVE: To evaluate an embryo transfer strategy for difficult transfers (DiTs). DESIGN: Prospective, nonrandomized, observational, cohort study SETTING: A hospital fertility center in France. PATIENT(S): Data were collected on all embryo transfers conducted using the strategy between February 201...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8244391/ https://www.ncbi.nlm.nih.gov/pubmed/34223272 http://dx.doi.org/10.1016/j.xfre.2020.11.004 |
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author | Larue, Lionel Bernard, Laure Moulin, Julie Massari, Anne Cassuto, Nino-Guy Bouret, Dominique Keromnes, Gwenola |
author_facet | Larue, Lionel Bernard, Laure Moulin, Julie Massari, Anne Cassuto, Nino-Guy Bouret, Dominique Keromnes, Gwenola |
author_sort | Larue, Lionel |
collection | PubMed |
description | OBJECTIVE: To evaluate an embryo transfer strategy for difficult transfers (DiTs). DESIGN: Prospective, nonrandomized, observational, cohort study SETTING: A hospital fertility center in France. PATIENT(S): Data were collected on all embryo transfers conducted using the strategy between February 2014 and February 2020. INTERVENTION(S): Anatomical characteristics that could cause DiT were identified by transvaginal ultrasound and the catheter was adapted accordingly. Transfer was guided by transvaginal ultrasound. After passage through the cervix, a rest period was introduced to allow any contractions to stop before embryo deposition in the uterus. MAIN OUTCOME MEASURE(S): The primary criterion was the percentage of pregnancies per transfer (P/T) after an easy transfer (EaT) or a DiT. The secondary criteria included the anatomical causes of DiT and the patients’ levels of discomfort. RESULT(S): Of 2,046 transfers, 257 (12%) were DiTs: minor difficulties (n = 152; 7.4%), major difficulties (n = 96; 4.7%), very significant difficulties (n = 7; 0.3%), or impossible (n = 2; 0.1%). The most common causes of DiTs were endocervical crypts (54%), tortuous cervical canal (36%), and marked uterine anteversions (30%). Several causes were often responsible for DiTs. There was no statistically significant difference in the P/T between the EaTs (n = 1,789, 41%) and all degrees of DiT (n = 257, 37%). In addition, there was no statistically significant difference between the level of patient-reported discomfort in the EaT and DiT groups. CONCLUSION(S): This study demonstrated that an adapted embryo transfer strategy, monitored by transvaginal ultrasound, led to similar pregnancy rates regardless of whether the transfer was easy or difficult. |
format | Online Article Text |
id | pubmed-8244391 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-82443912021-07-02 Evaluation of a strategy for difficult embryo transfers from a prospective series of 2,046 transfers Larue, Lionel Bernard, Laure Moulin, Julie Massari, Anne Cassuto, Nino-Guy Bouret, Dominique Keromnes, Gwenola F S Rep Original Article OBJECTIVE: To evaluate an embryo transfer strategy for difficult transfers (DiTs). DESIGN: Prospective, nonrandomized, observational, cohort study SETTING: A hospital fertility center in France. PATIENT(S): Data were collected on all embryo transfers conducted using the strategy between February 2014 and February 2020. INTERVENTION(S): Anatomical characteristics that could cause DiT were identified by transvaginal ultrasound and the catheter was adapted accordingly. Transfer was guided by transvaginal ultrasound. After passage through the cervix, a rest period was introduced to allow any contractions to stop before embryo deposition in the uterus. MAIN OUTCOME MEASURE(S): The primary criterion was the percentage of pregnancies per transfer (P/T) after an easy transfer (EaT) or a DiT. The secondary criteria included the anatomical causes of DiT and the patients’ levels of discomfort. RESULT(S): Of 2,046 transfers, 257 (12%) were DiTs: minor difficulties (n = 152; 7.4%), major difficulties (n = 96; 4.7%), very significant difficulties (n = 7; 0.3%), or impossible (n = 2; 0.1%). The most common causes of DiTs were endocervical crypts (54%), tortuous cervical canal (36%), and marked uterine anteversions (30%). Several causes were often responsible for DiTs. There was no statistically significant difference in the P/T between the EaTs (n = 1,789, 41%) and all degrees of DiT (n = 257, 37%). In addition, there was no statistically significant difference between the level of patient-reported discomfort in the EaT and DiT groups. CONCLUSION(S): This study demonstrated that an adapted embryo transfer strategy, monitored by transvaginal ultrasound, led to similar pregnancy rates regardless of whether the transfer was easy or difficult. Elsevier 2020-12-09 /pmc/articles/PMC8244391/ /pubmed/34223272 http://dx.doi.org/10.1016/j.xfre.2020.11.004 Text en © 2020 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Article Larue, Lionel Bernard, Laure Moulin, Julie Massari, Anne Cassuto, Nino-Guy Bouret, Dominique Keromnes, Gwenola Evaluation of a strategy for difficult embryo transfers from a prospective series of 2,046 transfers |
title | Evaluation of a strategy for difficult embryo transfers from a prospective series of 2,046 transfers |
title_full | Evaluation of a strategy for difficult embryo transfers from a prospective series of 2,046 transfers |
title_fullStr | Evaluation of a strategy for difficult embryo transfers from a prospective series of 2,046 transfers |
title_full_unstemmed | Evaluation of a strategy for difficult embryo transfers from a prospective series of 2,046 transfers |
title_short | Evaluation of a strategy for difficult embryo transfers from a prospective series of 2,046 transfers |
title_sort | evaluation of a strategy for difficult embryo transfers from a prospective series of 2,046 transfers |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8244391/ https://www.ncbi.nlm.nih.gov/pubmed/34223272 http://dx.doi.org/10.1016/j.xfre.2020.11.004 |
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