Ultrasound versus 'clinical touch' guidance during embryo transfer

Karen Buckingham

Since the first pregnancy using in vitro fertilisation (IVF) was achieved nearly 30 years ago, many aspects of the procedure, such as ovarian stimulation, oocyte recovery and the in vitro techniques of fertilization and embryo culture have undergone major revision.  In contrast, the technique of embryo transfer has remained largely unchanged.  Today, approximately 80% of women undergoing IVF/ICSI will reach the embryo transfer stage with good quality embryos.  However, only a small proportion will then go on to achieve a clinical pregnancy and fewer still will achieve a live birth.  This makes the embryo transfer phase the final and least successful step in assisted reproduction.  It is estimated that up to 85% of replaced embryos fail to implant, despite selecting apparently normal embryos for transfer.  This failure may be due to poor embryo quality, lack of uterine receptivity or the technique of embryo transfer itself.

A new review has found that IVF is more likely to be successful if embryos are transferred with the use of ultrasound, rather than the traditional clinical touch method. The ultrasound method gives women a 32% chance of viable pregnancy compared to 25% via the usual method. The clinical touch method is considered a blind technique, as it relies on the clinicians touch to guide the catheter to the correct position and then inject the embryos. With ultrasound-guided transfer (UGET), the chance of pregnancy is increased because it is easier for the clinician to confirm the catheter is in the right location before releasing the embryos.  Experts have supported the findings of this Cochrane Review, and recommend that women ask for the UGET approach as it may make a difference to achieving a pregnancy in some cases.

To read the full Cochrane Review, please click on the Link

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