Absolute position versus relative position in embryo transfer: a randomized controlled trial.

Area of Science:

• Reproductive Medicine
• In Vitro Fertilization (IVF)
• Embryo Transfer Techniques

Background:

• Previous meta-analysis indicated improved pregnancy outcomes with embryo placement 20 mm from the fundal endometrial surface compared to 10 mm.
• Higher pregnancy and implantation rates were observed when the embryo transfer catheter tip was positioned near the middle of the endometrial cavity.

Purpose of the Study:

• To evaluate the impact of embryo transfer (ET) catheter tip position on implantation and pregnancy rates.
• To compare outcomes between positioning the ET catheter tip 2 cm distant from the fundal endometrium (DFE) versus at the midpoint of the endometrial cavity length (ECL).

Main Methods:

• A randomized controlled trial involving 195 IVF-ET cycles.
• Patients were allocated to two groups: Group A (n=98) with ET tip positioned 2 cm DFE, and Group B (n=97) with ET tip positioned at the midpoint of the ECL.
• Key pregnancy outcomes including implantation, chemical, clinical, ongoing, ectopic, and miscarriage rates were compared.

Main Results:

• No significant differences were observed between the two groups in implantation rates (19.5% vs. 21.7%), chemical pregnancy rates (51% vs. 50.5%), clinical pregnancy rates (35.7% vs. 38.1%), or ongoing pregnancy rates (31.6% vs. 30.9%).
• Ectopic pregnancy rates (8.6% vs. 2.7%) and miscarriage rates (11.4% vs. 16.2%) were also comparable between the groups.
• Statistical analysis showed no significant p-values for any of the compared outcomes.

Conclusions:

• The site of embryo transfer catheter tip placement, whether 2 cm DFE or at the midpoint of the ECL, does not influence implantation and pregnancy rates.
• These findings suggest that precise positioning within this range may not be critical for successful IVF outcomes.