Volume 4, Issue 2 (7-2006)                   IJRM 2006, 4(2): 45-50 | Back to browse issues page

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Aflatoonian A, Asgharnia M. Factors affecting the successful embryo transfer. IJRM 2006; 4 (2) :45-50
URL: http://ijrm.ssu.ac.ir/article-1-57-en.html
Abstract:   (2496 Views)
The main factors affecting pregnancy and implantation rates are uterine receptivity, embryo quality, and transfer efficiency. Embryo transfer (ET) is the last step of critically important procedure of in vitro fertilization (IVF) and probably the least successful step in Assisted Reproductive Technology (ART) treatment cascade; though simple in most of the cases, it may pose to be the most difficult in some. No matter how good the IVF laboratory culture environment is, the physician can ruin everything with a carelessly performed embryo transfer. The entire IVF cycle depends on delicate placement of the embryos at the proper location near the middle of the endometrial cavity. Pregnancy rates will be significantly increased with the following procedures: 1. Trial transfer 2. Avoiding the initiation of uterine contractility by using soft catheters, gentle manipulation and by avoiding touching the fundus. 3. Removal of cervical mucus, wash and lavage of cervix with culture media. 4. Ultrasound-guided ET with full bladder. 5. Deposition of the embryo 2 cm below the uterine fundus. 6. Examination of catheter following transfer for retained embryos, blood and mucus. Slow withdrawal of the embryo transfer catheter, the use of a fibrin sealant, bed rest after embryo transfer, sexual intercourse and routine administration of antibiotics following embryo transfer remained to be studied by randomized clinical trials (RCTs).
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1. Gardner DK, Weissman A, Howeles CM, Shoham Z. In: textbook of assisted reproductive techniques laboratory and clinical perspectives. First edition. United kingdom: Martin dunitz; 2001. Schoolcraft WB. Embryo transfer: 623-626.
2. Kovacs GT. What factors are important for successful embryo transfer after in vitro fertilization? Hum Reprod 1999;14:590-592. [DOI:10.1093/humrep/14.3.590] [PMID]
3. Karande VC, Morris R, Chapman C, Rinehart J, Gleicher N. Impact of the "physician factor" on pregnancy rates in a large assisted reproductive technology program: do too many cooks spoil the broth? Fertil Steril 1999;71:1001-1009. [DOI:10.1016/S0015-0282(99)00139-9]
4. Hearns-Stokes RM, Miller BT, Scott L, Creuss D, Chakraborty PK, Segars JH. Pregnancy rates after embryo transfer depend on the provider at embryo transfer. Fertil Steril 2000;74:80-86. [DOI:10.1016/S0015-0282(00)00582-3]
5. Papageorgiou T, Hearns-stokes RM, Leondires MP, Miller BT, Chakrabarty P, Cruess D. Training of providersin embryo transfer: what is the minimum number of transfers required for proficiency? Hum Reprod 2001;16:1415-1419. [DOI:10.1093/humrep/16.7.1415] [PMID]
6. Mansour R, Aboulghar M, Serour G. Dummy embryo transfer: a technique that minimizes the problems of embryo transfer and improves the pregnancy rate in human in vitro fertilization. Fertil. Steril 1990;54:678-681. [DOI:10.1016/S0015-0282(16)53829-1]
7. Wood C, McMaster R, Rennie G, Trounson A, Leeton J. Factors influencing pregnancy rates following in vitro fertilization and embryo transfer. Fertil. Steril 1985;43:245-250. [DOI:10.1016/S0015-0282(16)48380-9]
8. Noyes N, Licciardi F, Grifo J, Krey L. Berkeley A. In vitro fertilization outcome relative to embryo transfer difficulty: a novel approach to the forbidden cervix. Fertil Steril 1999;72:261-265. [DOI:10.1016/S0015-0282(99)00235-6]
9. Kato O, Kataksuka R, Asch RH. Transvaginal-transmyometrial embryo transfer: the Towako method; experience of 104 cases. Fertil Steril 1993;59:51-53. [DOI:10.1016/S0015-0282(16)55613-1]
10. Asaad M, Carver-Ward JA. Twin pregnancy following transmyometrial-subendometrial embryo transfer for repeated implantation failure. Hum Reprod 1997;12:2824-2825. [DOI:10.1093/humrep/12.12.2824] [PMID]
11. Groutz A, Lessing JB, Wolf Y, Azem F, Yovel I, Amit A. Comparison of transmyometrial and transcervical embryo transfer in patients with previously failed in vitro fertilization-embryo transfer cycles and/or cervical stenosis. Fertil Steril 1997;67:1073-1076. [DOI:10.1016/S0015-0282(97)81441-0]
12. Naruka DS. Vaginosonographically assisted embryo transfer following IVF. In: Transvaginal sonography in infertility. Allahbadia G, first edition, Shah DR. 1998:224-227.
13. Mansour R, Aboulghar A, SerourG, Amin Y. Dummy embryo transfer using methylene blue dye. Hum Reprod 1994;9:1257-1259. [DOI:10.1093/oxfordjournals.humrep.a138690] [PMID]
14. Prapas N, Prapas Y, Panagiotidis Y, Prapa S, Vanderzwalmen P, Makedos G. Cervical dilatation has a positive impact on the outcome of IVF in randomly assigned cases having two previous difficult embryo transfers. Hum Reprod 2004;19(8):1791-1795. [DOI:10.1093/humrep/deh320] [PMID]
15. Poindexter AN 3rd, Thompson DJ, Gibbons WE, Findley WE, Dodson MG, Young RL. Residual embryos in failed embryo transfer. Fertil Steril 1986;46(2):262-267. [DOI:10.1016/S0015-0282(16)49523-3]
16. Awonuga A, Nabi A, Ggovindbhai J, Birch H, Stewart B. Contamination of embryo transfer catheter and treatment outcome in In Vitro Fertilization. J Assist Reprod Genet 1998;15;198-201.
17. Aflatoonian A, Asgharnia M, Tabibnejad N. Effect of cervical mucus aspiration with insulin syringe on pregnancy rate in ART cycles. Scientific Journal of Rafsanjan University of Medical Sciences & Health Services 2005;4(2):65-71 (In Persian).
18. Pabuccu R, Ceyhan ST, Onalan G, Goktolga U, Ercan CM, Selam B. Successful treatment of cervical stenosis with hysteroscopic canalization before embryo transfer in patients undergoing IVF: a case series. J Minim Invasive Gynecol 2005;12(5):436-438. [DOI:10.1016/j.jmig.2005.06.003] [PMID]
19. Nabi A, Awonuga A, Birch H, Barlow S, Stewart B. Multiple attempts at embryo transfer: does this affect in-vitro fertilization treatment outcome? Hum Reprod1997;12(6):1188-1190. [DOI:10.1093/humrep/12.6.1188] [PMID]
20. Bar-Hava I, Kerner R, Yoeli R, Ashkenazi J, Shalev Y, Orvieto R. Immediate ambulation after embryo transfer: a prospective study. Fertil Steril 2005;83(3):594-597. [DOI:10.1016/j.fertnstert.2004.07.972] [PMID]
21. Amarin ZO, Obeidat BR. Bed rest versus free mobilisation following embryo transfer: a prospective randomised study. BJOG 2004;111(11):1273-1276. [DOI:10.1111/j.1471-0528.2004.00346.x] [PMID]
22. Mansour RT, Aboulghar MA. Optimizing the embryo transfer technique. Hum Reprod 2002;17(5):1149-1153. [DOI:10.1093/humrep/17.5.1149] [PMID]
23. Coroleu PN, Barri O, Carreras F, Martinez M, Parriego L, Hereter N, et al. The influence of the depth of embryo replacement into the uterine cavity on implantation rates after IVF: a controlled, ultrasound-guided study, Hum Reprod 2002;17:341-346. [DOI:10.1093/humrep/17.2.341] [PMID]
24. Neithardt AB, Segars JH, Hennessy S, James AN, McKeeby JL. Embryo afterloading: a refinement in embryo transfer technique that may increase clinical pregnancy. Fertil Steril 2005;83(3):710-714. [DOI:10.1016/j.fertnstert.2004.08.022] [PMID] [PMCID]
25. Mocanu EV, Adala S, O'Leary JJ. womb with a view. Hum Fertil (Camb) 2005;8(1):35-40. [DOI:10.1080/14647270500030316] [PMID]
26. McIlveen M, Lok FD, Pritchard J, Lashen H. Modern embryo transfer catheters and pregnancy outcome: a prospective randomized trial. Fertil Steril 2005;84(4):996-1000. [DOI:10.1016/j.fertnstert.2005.06.018] [PMID]
27. Bucket WM. A meta-analysis of ultrasound-guided versus clinical touch embryo transfer. Fertil Steril 2003;80:1037-1041. [DOI:10.1016/S0015-0282(03)01015-X]
28. Silberstein T, Trimarchi JR, Shackelton R, Weitzen S, Frankfurter D, Plosker S. Ultrasound-guided miduterine cavity embryo transfer is associated with a decreased incidence of retained embryos in the transfer catheter. Fertil Steril 2005;84(5):1510-1512. [DOI:10.1016/j.fertnstert.2005.06.023] [PMID]
29. Sallam HN, Sadek SS. Ultrasound-guided embryo transfer: a meta-analysis of randomized controlled trials. Fertil Steril 2003;80:1042-1046. [DOI:10.1016/S0015-0282(03)01009-4]
30. Frydman R. Impact of embryo transfer techniques on implantation rates. Gynecol Obstet Biol Reprod (Paris) 2004;33(1Pt2):S36-39.
31. Woolcott R, Stanger J. Potentially important variables identified by transvaginal ultrasound- guided embryo transfer. Hum Reprod 1997;12:963-966. [DOI:10.1093/humrep/12.5.963] [PMID]
32. Knutzen V, Stratton CJ, Sher G, MCNamee PI, Huang TT, Soto-Albors C. Mock embryo transfer in early luteal phase, the cycle before in vitro fertilization and embryo transfer: a descriptive study. Fertil Steril 1992;57:156-162. [DOI:10.1016/S0015-0282(16)54793-1]
33. Mansour R. Minimizing embryo expulsion after embryo transfer: a randomized controlled study. Hum Reprod 2005;20(1):170-174. [DOI:10.1093/humrep/deh573] [PMID]
34. Tremellen KP, Valbuena D, Landeras J, Ballesteros A, Martinez J, Mendoza S, et al. The effect of intercourse on pregnancy rates during assisted human reproduction. Hum Reprod 2000;15:2653-2658. [DOI:10.1093/humrep/15.12.2653] [PMID]
35. Lewin A, Schenker JG, Avrech O, Shapira S, Safran A, Friedler S. The role of uterine straightening by passive bladder distension before embryo transfer in IVF cycles. J Assist Reprod Genet 1997;14:32-34. [DOI:10.1007/BF02765749] [PMID] [PMCID]
36. Sallam HN, Agameya AF, Rahman AF, Ezzeldin F, Sallam AN. Ultrasound measurement of the utero-cervical angle prior to embryo transfer - a prospective controlled study. Hum Reprod 2002;17:1767-1772. [DOI:10.1093/humrep/17.7.1767] [PMID]
37. Lewin A, Schenker JG, Avrech O, Shapira S, Safran A, Friedler S. The role of uterine straightening by passive bladder distension before embryo transfer in IVF cycles. J Assist Reprod Genet 1997;14:32-34. [DOI:10.1007/BF02765749] [PMID] [PMCID]
38. Martinez F, Coroleu B, Parriego M, Carreras O, Belil I, Parera N, et al. Ultrasound-guided embryo transfer: immediate withdrawal of the catheter versus a 30 second wait. Hum Reprod 2001;16:871-874. [DOI:10.1093/humrep/16.5.871] [PMID]
39. Sallam H, Sadek S, Ezzeldin F. Does cervical infection affect the results of IVF and ICSI? A meta-analysis of controlled studies. Fertil Steril 2003;80:S110. [DOI:10.1016/S0015-0282(03)02090-9]
40. Bar-Hava H, Krissi J, Ashkenazi R, Orvieto M, Shelef Z, Ben-Rafael. Fibrin glue improves pregnancy rates in women of advanced reproductive age and in patients in whom in vitro fertilization attempts repeatedly fail. Fertil Steril 1999;71:821-824. [DOI:10.1016/S0015-0282(99)00066-7]

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