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...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-03-01
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| Series: | F&S Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666334120301239 |
| _version_ | 1818722153635250176 |
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| author | Lionel Larue, M.D., Ph.D. Laure Bernard, M.D. Julie Moulin, M.D. Anne Massari, M.D. Nino-Guy Cassuto, Ph.D. Dominique Bouret, M.D. Gwenola Keromnes, M.D. |
| author_facet | Lionel Larue, M.D., Ph.D. Laure Bernard, M.D. Julie Moulin, M.D. Anne Massari, M.D. Nino-Guy Cassuto, Ph.D. Dominique Bouret, M.D. Gwenola Keromnes, M.D. |
| author_sort | Lionel Larue, M.D., Ph.D. |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-12-17T20:50:06Z |
| format | Article |
| id | doaj.art-52025d1d2d4b404f9c957cb784b355fa |
| institution | Directory Open Access Journal |
| issn | 2666-3341 |
| language | English |
| last_indexed | 2024-12-17T20:50:06Z |
| publishDate | 2021-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | F&S Reports |
| spelling | doaj.art-52025d1d2d4b404f9c957cb784b355fa2022-12-21T21:33:03ZengElsevierF&S Reports2666-33412021-03-01214349Evaluation of a strategy for difficult embryo transfers from a prospective series of 2,046 transfersLionel Larue, M.D., Ph.D.0Laure Bernard, M.D.1Julie Moulin, M.D.2Anne Massari, M.D.3Nino-Guy Cassuto, Ph.D.4Dominique Bouret, M.D.5Gwenola Keromnes, M.D.6Centre de Fertilité - Groupe Hospitalier Diaconesses Croix Saint Simon, Paris, France; Reprint requests: Lionel Larue, M.D., Ph.D., Centre de Fertilité – Groupe Hospitalier Diaconesses Croix Saint Simon, 18, Rue du Sergent Bauchat, 75012 Paris, France.Centre de Fertilité - Groupe Hospitalier Diaconesses Croix Saint Simon, Paris, FranceCentre de Fertilité - Groupe Hospitalier Diaconesses Croix Saint Simon, Paris, FranceCentre de Fertilité - Groupe Hospitalier Diaconesses Croix Saint Simon, Paris, FranceLaboratoire Drouot, Paris, FranceLaboratoire Drouot, Paris, FranceCentre de Fertilité - Groupe Hospitalier Diaconesses Croix Saint Simon, Paris, FranceObjective: 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.http://www.sciencedirect.com/science/article/pii/S2666334120301239Embryo transferdifficult transferin vitro fertilizationtransvaginal ultrasoundpersonalized healthcare |
| spellingShingle | Lionel Larue, M.D., Ph.D. Laure Bernard, M.D. Julie Moulin, M.D. Anne Massari, M.D. Nino-Guy Cassuto, Ph.D. Dominique Bouret, M.D. Gwenola Keromnes, M.D. Evaluation of a strategy for difficult embryo transfers from a prospective series of 2,046 transfers F&S Reports Embryo transfer difficult transfer in vitro fertilization transvaginal ultrasound personalized healthcare |
| 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 | Embryo transfer difficult transfer in vitro fertilization transvaginal ultrasound personalized healthcare |
| url | http://www.sciencedirect.com/science/article/pii/S2666334120301239 |
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