Comparison between conventional blind embryo transfer and embryo transfer based on previously measured uterine length

ABSTRACT

Embryo transfer [ET] is one of the most important steps in assisted reproductive technology [ART] cycles and affected by many factors namely the depth of embryo deposition in uterus. In this study, the outcomes of intracytoplasmic sperm injection [ICSI] cycles after blind embryo transfer and embryo transfer based on previously measured uterine length using vaginal ultrasound were compared. This prospective randomised clinical trial included one hundred and forty non-donor fresh embryo transfers during January 2010 to June 2011. In group I, ET was performed using conventional [blind] method at 5-6 cm from the external os, and in group II, ET was done at a depth of 1-1.5 cm from the uterine fundus based on previously measured uterine length using vaginal sonography. Appropriate statistical analysis was performed using Student's t test and Chi-square or Fisher's exact test. The software that we used was PASW statistics version 18. A p value <0.05 was considered statistically significant. Chemical pregnancy rate was 28.7% in group I and 42.1% in group II, while the difference was not statistically significant [p=0.105]. Clinical pregnancy, ongoing pregnancy and implantation rates for group I were 21.2%, 17.7%, and 12.8%, while for group II were 33.9%, 33.9%, and 22.1, respectively. In group I and group II, abortion rates were 34.7% and 0%, respectively, indicating a statistically significant difference [p<0.005]. No ectopic pregnancy occurred in two groups. The use of uterine length measurement during treatment cycle in order to place embryos at depth of 1-1.5 cm from fundus significantly increases clinical and ongoing pregnancy and implantation rates, while leads to a decrease in abortion rate [Registration Number IRCT2014032512494N1]