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Interim analysis of a randomized clinical trial comparing abdominal versus transvaginal ultrasound‐guided embryo transfer
Author(s) -
Porat Natalie,
Boehnlein Lynn M.,
Schouweiler Calisa M.,
Kang Jungae,
Lindheim Steven R.
Publication year - 2010
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/j.1447-0756.2009.01148.x
Subject(s) - medicine , embryo transfer , pregnancy , transabdominal ultrasound , randomized controlled trial , ultrasound , gynecology , in vitro fertilisation , obstetrics , live birth , transvaginal ultrasound , pregnancy rate , distension , surgery , radiology , genetics , biology
Aim: Ultrasound‐guided embryo transfer appears to improve overall pregnancy outcomes for in vitro fertilization embryo transfer cycles. Most reports are done using a transabdominal ultrasound‐guided approach, in contrast to a transvaginal ultrasound, which does not require a full bladder. We sought to determine if either approach was better with respect to clinical pregnancy outcomes. Methods: This randomized clinical trial took place in a university‐based practice with an enrollment of 186 subjects. Secondary measures also included embryo transfer time and degree of cramping and pain, which subjects ranked as none = 1; mild = 2; moderate = 3; or severe = 4 . Results: There were no differences in implantation rates (33.1 ± 4.1%, ± standard error vs 31.1 ± 3.9%, P = 0.78), pregnancy rates (60% vs 54%, P = 0.38), clinical pregnancy rates (48% vs 45%, P = 0.77), and live‐birth rates (30% vs 39%, P = 0.37) between transabdominal and transvaginal ultrasound‐guided embryo transfer groups. No differences were noted between groups for time required for embryo transfer (157 ± 279 seconds vs 130 ± 176 seconds, P = 0.92), uterine cramping (1.2 ± 0.5 vs 1.2 ± 0.4, P = 0.4), and the degree of pain (1.4 ± 0.7 vs 1.3 ± 0.5, P = 0.13). Conclusions: Neither transabdominal nor transvaginal ultrasound‐guided embryo transfer is more beneficial in optimizing pregnancy outcomes. While delays often occur while waiting for bladder distension for transabdominal ultrasound‐guided embryo transfer, uterine position, parity and level of physician comfort should dictate the choice of either approach.