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Updated: Mar 6, 2026
Minimally Invasive Embryo Transfer and Embryo Vitrification at the Optimal Embryo Stage in Rabbit Model
Published on: May 16, 2019
Embryo transfer simulation improves pregnancy rates and decreases time to proficiency in Reproductive Endocrinology
Ryan J Heitmann1, Micah J Hill2, John M Csokmay3
1Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, Bethesda, Maryland; Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Madigan Army Medical Center, Tacoma, Washington.
Objective:
To design and evaluate an ET simulator to train Reproductive Endocrinology and Infertility (REI) fellows' techniques of ET.
Design:
Simulation model development and retrospective cohort analysis.
Setting:
Not applicable.
Patient(S):
Patients undergoing IVF.
Intervention(S):
Simulation model evaluation and implementation of ET simulation training.
Main Outcome Measure(S):
Pregnancy rates.
Result(S):
The REI fellow and faculty evaluation responses (n = 19/21 [90%]) of the model demonstrated realistic characteristics, with evaluators concluding the model was suitable for training in almost all evaluated areas. A total of 12 REI fellows who performed ET were analyzed: 6 before ET trainer and 6 after ET trainer. Pregnancy rates were 31% in the initial 10 ETs per fellow before simulator vs. 46% after simulator. One of six pre-ET trainer fellows (17%) had pregnancy rates ≥40% in their first 10 ETs; whereas four of six post-ET trainer fellows had pregnancy rates ≥40% in their first 10 ETs. The average number of ETs to obtain >40% pregnancy efficiency was 27 ETs before trainer vs. 15 ETs after trainer. Pregnancy rates were similar in the two groups after 20 ETs, and collective terminal pregnancy rates were >50% after 40 ETs.
Conclusion(S):
Embryo transfer simulation improved REI fellow pregnancy rates in their first 10 transfers and led to a more rapid ET proficiency. These data suggest potential value in adopting ET simulation, even in programs with a robust history of live ET in fellowship training.
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