Embryo transfer training in fellowship: national and institutional data

Area of Science:

• Reproductive Medicine
• In Vitro Fertilization
• Medical Education

Background:

• Embryo transfer (ET) is a critical procedure in assisted reproductive technology.
• Standardized training and competency assessment in ET are essential for fellows in reproductive endocrinology and infertility (REI) programs.
• Variability in ET training may impact fellow proficiency and patient outcomes.

Purpose of the Study:

• To assess current national practices in embryo transfer (ET) training within U.S. REI fellowship programs.
• To compare live birth rates after ET performed by fellows versus attending physicians.
• To identify disparities in ET training experiences among fellows.

Main Methods:

• A cross-sectional survey was administered to U.S. REI fellowship program directors and fellows in 2019.
• A retrospective cohort study analyzed IVF cycle outcomes for embryo transfers (ETs) from 2015-2018.
• Data included fellow ET experience and live birth rates for fellow- versus attending-performed ETs.

Main Results:

• Twenty-one percent of surveyed programs reported no ETs performed by fellows.
• Forty-four percent of third-year fellows had performed fewer than ten ETs during their training.
• No significant difference in live birth rates was observed between fellows (51.6%) and attending physicians (49.4%) for blastocyst ETs.

Conclusions:

• Significant variability exists in the adequacy of ET training across U.S. REI fellowship programs.
• With appropriate supervision, fellows achieve comparable live birth rates to attending physicians in embryo transfer.
• Addressing barriers to ET training and establishing minimum procedural benchmarks for fellows is recommended.