ABSTRACT
OBJECTIVE: To compare two flexible catheters and determine whether pregnancy rates (PRs) differed. DESIGN: Prospective, randomized pilot study. SETTING: Tertiary-care infertility practice. PATIENT(S): The subjects for this study were 100 women undergoing assisted reproductive technology (ART) cycles between September 2003 and October 2005. INTERVENTION(S): None. MAIN OUTCOME MEASURE: Clinical PR for Edwards-Wallace (Cooper Surgical, Shelton, CT) and Cook World (Cook Urological, Spencer, IN) embryo-transfer (ET) catheters. RESULT(S): The outcomes of pregnancy between the Edwards-Wallace and Cook World ET catheters were not significantly different. Use of the flare stimulation protocol resulted in a significantly lower PR compared to long luteal and antagonist protocols. No other variable affected PR. CONCLUSION(S): A 5% difference in PR was demonstrated between ET catheters; however, this study does not have the power to detect a significant difference in clinical PR between the two catheter groups. The pilot study demonstrates good design due to the lack of significant differences between the variables when stratifed by cather as well as pregnancy status. In a larger study, the flare protocol should be excluded.
Subject(s)
Catheterization/statistics & numerical data , Embryo Transfer/instrumentation , Embryo Transfer/statistics & numerical data , Infertility, Female/epidemiology , Infertility, Female/therapy , Pregnancy Rate , Adult , Equipment Design , Equipment Failure Analysis , Female , Humans , Pilot Projects , Pregnancy , Treatment OutcomeABSTRACT
PURPOSE: To determine factors instrumental in achieving a clinical pregnancy in assisted reproductive technology (ART) patients. METHODS: This study included 205 women undergoing their first ART cycle. Univariate and multivariate analyses were performed for patient demographics, in vitro production data, and factors associated with embryo transfer. Odds ratios (OR) were performed where appropriate. RESULTS: Our analyses indicated that age (OR: 0.879), specific year in which the cycle was performed (OR: 2.959), and use of intracytoplasmic sperm injection (OR: 2.867) altered potential pregnancy rate. In addition, percent fertilization (OR: 1.028), number of embryos transferred (OR: 1.842), type of catheter used to transfer the embryos (OR: 0.377), presence of blood on the catheter (OR .414), and embryologist (OR: 2.338) also altered pregnancy rate. CONCLUSIONS: Our data indicate patients' age, use of the Cook catheter, and presence of blood on the catheter reduce pregnancy rates. Performing ART in 1999, using ICSI, increasing fertilization rate, increasing number of embryos transferred (albeit less desirable when the chance of multiple gestation may occur), and transferring embryos via a particular embryologist, improve pregnancy rates.
