Effect of air bubbles localization and migration after embryo transfer on assisted reproductive technology outcome
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109
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2
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Objective: To evaluate the effect of embryo flash position and movement of the air bubbles at 1 and 60 minutes after ET on clinical pregnancy rates (PRs). Design: Prospective clinical trial. Setting: University fertility clinic. Patient(s): A total of 230 fresh ultrasound-guided ETs performed by a single physician (C.F.) at the IVF center of Yeditepe University Hospital between September 2016 and February 2017 were included. Intervention(s): Transabdominal ultrasonographic guidance at ET. Main Outcome Measure(s): Clinical PRs. Result(s): There was no significant difference in terms of clinical PRs between women with embryo flash located >15 mm and <15 mm from the fundus at 1 or 60 minutes (P= .6 and P= .7, respectively). The PRs in women with embryo flash located <15 mm and >15 mm from the fundus were 47\% and 60\%, respectively (P= .6). The clinical intrauterine PRs were 69.5\%, 38.5\%, and 19.1\% in fundal, static, and cervical, respectively. The highest PR was in fundal when compared with others (P< .01). The clinical PR appears to be associated with the embryo flash movement/migration and the PR was dramatically reduced when the embryo migrated from its original position toward the cervix at 60 minutes. Conclusion(s): We concluded that clinical PR appears to be associated with the embryo flash movement/migration at 60 minutes after Er and embryo flash movement toward the fundus is associated with higher clinical PRs. Further well-designed randomized controlled trials are required to optimize ET technique in the future. (C) 2017 by American Society for Reproductive Medicine.