Methods employed to overcome difficult embryo transfer during assisted reproduction treatment

Area of Science:

• Reproductive Medicine
• Infertility Treatment
• Assisted Reproduction Technology

Background:

• Embryo transfer is a critical step in assisted reproduction technology (ART), directly influencing treatment success.
• Difficult embryo transfers pose significant challenges for clinicians and negatively affect patient outcomes, potentially leading to implantation failure.
• Anatomical difficulties during embryo transfer can cause trauma and uterine contractions, compromising the success of ART procedures.

Purpose of the Study:

• To review existing literature on interventions used to manage difficult embryo transfers during ART.
• To identify and categorize methods employed to overcome challenges in embryo transfer procedures.
• To highlight the need for standardized approaches and further research in managing difficult embryo transfers.

Main Methods:

• A comprehensive literature review was conducted, examining published studies on interventions for difficult embryo transfers in ART.
• Studies were analyzed to identify and group different techniques used to facilitate embryo transfer.
• The review included case reports, case series, and randomized controlled trials (RCTs) addressing embryo transfer challenges.

Main Results:

• Five distinct methods were identified across 17 studies to address difficult embryo transfers.
• Interventions included hysteroscopic methods, use of Malecot catheters, various dilators (hygroscopic and mechanical), intrafollopian transfer, and transmyometrial embryo transfers.
• The majority of identified studies were case reports or case series, with only two RCTs found.

Conclusions:

• There is a lack of a uniform classification or grading system for difficult embryo transfers in the current literature.
• A grading system for embryo transfer difficulty has been proposed within this review.
• Consensus guidelines and large-scale multicenter RCTs are recommended to compare intervention effectiveness for difficult embryo transfers.