Document Detail


Interim analysis of a randomized clinical trial comparing abdominal versus transvaginal ultrasound-guided embryo transfer.
MedLine Citation:
PMID:  20492392     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: Ultrasound-guided embryo transfer appears to improve overall pregnancy outcomes for in vitro fertilization embryo transfer cycles. Most reports are done using a transabdominal ultrasound-guided approach, in contrast to a transvaginal ultrasound, which does not require a full bladder. We sought to determine if either approach was better with respect to clinical pregnancy outcomes.
METHODS: This randomized clinical trial took place in a university-based practice with an enrollment of 186 subjects. Secondary measures also included embryo transfer time and degree of cramping and pain, which subjects ranked as none = 1; mild = 2; moderate = 3; or severe = 4.
RESULTS: There were no differences in implantation rates (33.1 + or - 4.1%, + or - standard error vs 31.1 + or - 3.9%, P = 0.78), pregnancy rates (60% vs 54%, P = 0.38), clinical pregnancy rates (48% vs 45%, P = 0.77), and live-birth rates (30% vs 39%, P = 0.37) between transabdominal and transvaginal ultrasound-guided embryo transfer groups. No differences were noted between groups for time required for embryo transfer (157 + or - 279 seconds vs 130 + or - 176 seconds, P = 0.92), uterine cramping (1.2 + or - 0.5 vs 1.2 + or - 0.4, P = 0.4), and the degree of pain (1.4 + or - 0.7 vs 1.3 + or - 0.5, P = 0.13).
CONCLUSIONS: Neither transabdominal nor transvaginal ultrasound-guided embryo transfer is more beneficial in optimizing pregnancy outcomes. While delays often occur while waiting for bladder distension for transabdominal ultrasound-guided embryo transfer, uterine position, parity and level of physician comfort should dictate the choice of either approach.
Authors:
Natalie Porat; Lynn M Boehnlein; Calisa M Schouweiler; Jungae Kang; Steven R Lindheim
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The journal of obstetrics and gynaecology research     Volume:  36     ISSN:  1447-0756     ISO Abbreviation:  J. Obstet. Gynaecol. Res.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-05-24     Completed Date:  2010-08-20     Revised Date:  2012-01-19    
Medline Journal Info:
Nlm Unique ID:  9612761     Medline TA:  J Obstet Gynaecol Res     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  384-92     Citation Subset:  IM    
Affiliation:
Obstetrics and Gynecology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA.
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MeSH Terms
Descriptor/Qualifier:
Abdomen / ultrasonography*
Chi-Square Distribution
Embryo Implantation
Embryo Transfer / methods*
Female
Fertilization in Vitro / methods
Humans
Pregnancy
Pregnancy Outcome
Pregnancy Rate
Treatment Outcome
Ultrasonography / methods*
Uterus / ultrasonography*
Vagina / ultrasonography*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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