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The human factor: does the operator performing the embryo transfer significantly impact the cycle outcome?
F Cirillo1, P Patrizio2, M Baccini3
1Department of Gynecology, Division of Gynecology and Reproductive Medicine, Fertility Center, Humanitas Clinical and Research Center, IRCCS, via Manzoni 56, Rozzano, 20089 Milan, Italy.
Human Reproduction (Oxford, England)
|February 27, 2020
Summary
Ongoing pregnancy rate (OPR) in embryo transfer (ET) is operator-dependent. Operator experience does not guarantee improved success rates, highlighting the need for objective standardization and performance analysis in assisted reproduction.
Area of Science:
- Reproductive Medicine
- In Vitro Fertilization (IVF)
- Embryo Transfer (ET) Techniques
Background:
- Embryo transfer (ET) is a critical step in assisted reproduction, influencing implantation success.
- While embryo quality and uterine receptivity are key, the ET technique itself is operator-dependent.
Purpose of the Study:
- To investigate if ongoing pregnancy rate (OPR) is operator-dependent.
- To determine if operator experience improves embryo transfer efficiency.
Main Methods:
- Retrospective analysis of 19,824 fresh IVF/ICSI embryo transfers performed by 32 operators.
- Statistical analysis using logistic regression and meta-analysis to assess operator variability and the impact of experience on OPR.
Main Results:
- Significant heterogeneity in OPR among operators (P < 0.001), explaining 44.5% of the variability.
- Operator success rates varied, with odds ratios ranging from 0.84 (worst) to 1.13 (best) relative to the mean.
- On average, operator performance did not significantly improve with increased experience.
Conclusions:
- Embryo transfer success is significantly influenced by the individual operator, not solely by experience.
- Objective standardization of ET techniques and continuous performance monitoring are crucial for improving efficiency in assisted reproduction.
