Pregnancy outcome after difficult embryo transfer in IVF-ET cycles
Najlaa Shamil Mahmod;
Abstract
Embryo transfer (ET) is one of the most crucial steps in IVF/ICSI treatment. Although it, apparently, seems simple, it is an integral part of IVF/ICSI and can affect the outcome of the whole treatment cycle (Brauer and Schuttman, 2014).
The majority of couples (approximately 80%) who undergo IVF reach the ET stage, yet few pregnancies occur. The pregnancy rate after ET is dependent on multiple factors including embryo quality, endometrial receptivity, and the technique of the ET. The latter might be directly responsible for a lot of unsuccessful embryo implantations. However, comparatively less attention has been paid to ET techniques than IVF technique. Recently, many investigators have identified the relationship between IVF outcome and different techniques and they have noted a pregnancy rate of 33.3% for “excellent” transfers, and 10.5% for “poor” transfers (Punhani et al., 2016).
The impact of difficult ET on pregnancy outcome is well known. Although some reports show no harmful effect (Burke et al., 2000; Tur-Kaspa et al., 1998), most of studies show a detrimental effect on IVF outcome (Mains and Voorhis,2010; Sallam and Agameya, 2014; Neithardt et al., 2005). It has been estimated that poor ET technique accounts for as high as 30% of IVF/ICSI failures (Ghaffari et al., 2013).
In addition to the evident association between difficult ET and negative pregnancy outcome, an association between difficult ET and first trimester miscarriage, among women who had initially a positive clinical pregnancy outcome, has been practically and clinically observed. The aim of the current study was to assess the association between difficult ET and ongoing clinical pregnancy outcome.
The current study showed a significantly reduced IVF/ICSI cycle outcomes among women who had difficult ET. Difficult ET was significantly associated with almost 2-fold reduction in biochemical pregnancy rate [OR 0.5, 95% CI (0.31 to 0.83), p=0.006], almost 2-fold reduction in clinical pregnancy rate [OR 0.48, 95% CI (0.29 to 0.79), p=0.004], and almost 3-fold reduction in ongoing clinical pregnancy rate [20 (24.4%) vs. 158 (47.2%), respectively; OR 0.36, 95% CI (0.21 to 0.62), p<0.001]. A binary logistic regression analysis showed that difficult ET is independently associated with negative ongoing clinical pregnancy outcome [OR 0.33, 95% CI (0.19 to 0.58), p<0.001].
The majority of couples (approximately 80%) who undergo IVF reach the ET stage, yet few pregnancies occur. The pregnancy rate after ET is dependent on multiple factors including embryo quality, endometrial receptivity, and the technique of the ET. The latter might be directly responsible for a lot of unsuccessful embryo implantations. However, comparatively less attention has been paid to ET techniques than IVF technique. Recently, many investigators have identified the relationship between IVF outcome and different techniques and they have noted a pregnancy rate of 33.3% for “excellent” transfers, and 10.5% for “poor” transfers (Punhani et al., 2016).
The impact of difficult ET on pregnancy outcome is well known. Although some reports show no harmful effect (Burke et al., 2000; Tur-Kaspa et al., 1998), most of studies show a detrimental effect on IVF outcome (Mains and Voorhis,2010; Sallam and Agameya, 2014; Neithardt et al., 2005). It has been estimated that poor ET technique accounts for as high as 30% of IVF/ICSI failures (Ghaffari et al., 2013).
In addition to the evident association between difficult ET and negative pregnancy outcome, an association between difficult ET and first trimester miscarriage, among women who had initially a positive clinical pregnancy outcome, has been practically and clinically observed. The aim of the current study was to assess the association between difficult ET and ongoing clinical pregnancy outcome.
The current study showed a significantly reduced IVF/ICSI cycle outcomes among women who had difficult ET. Difficult ET was significantly associated with almost 2-fold reduction in biochemical pregnancy rate [OR 0.5, 95% CI (0.31 to 0.83), p=0.006], almost 2-fold reduction in clinical pregnancy rate [OR 0.48, 95% CI (0.29 to 0.79), p=0.004], and almost 3-fold reduction in ongoing clinical pregnancy rate [20 (24.4%) vs. 158 (47.2%), respectively; OR 0.36, 95% CI (0.21 to 0.62), p<0.001]. A binary logistic regression analysis showed that difficult ET is independently associated with negative ongoing clinical pregnancy outcome [OR 0.33, 95% CI (0.19 to 0.58), p<0.001].
Other data
| Title | Pregnancy outcome after difficult embryo transfer in IVF-ET cycles | Other Titles | نسبة حدوث الحمل بعد إرجاع الأجنة الصعب إثناء الحقن ألمجهري | Authors | Najlaa Shamil Mahmod | Issue Date | 2017 |
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