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Fertil Steril. 2017 Apr;107(4):1003-1011. doi: 10.1016/j.fertnstert.2016.10.040.

Embryo transfer techniques: an American Society for Reproductive Medicine survey of current Society for Assisted Reproductive Technology practices.

Author information

1
Vincent Reproductive Medicine and IVF, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: TLTOTH@partners.org.
2
Vincent Reproductive Medicine and IVF, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
3
USC Fertility, University of Southern California, Los Angeles, California.
4
University of Alabama, Birmingham, Alabama.

Abstract

OBJECTIVE:

To better understand practice patterns and opportunities for standardization of ET.

DESIGN:

Cross-sectional survey.

SETTING:

Not applicable.

PATIENT(S):

Not applicable.

INTERVENTION(S):

An anonymous 82-question survey was emailed to the medical directors of 286 Society for Assisted Reproductive Technology member IVF practices. A follow-up survey composed of three questions specific to ET technique was emailed to the same medical directors. Descriptive statistics of the results were compiled.

MAIN OUTCOME MEASURE(S):

The survey assessed policies, protocols, restrictions, and specifics pertinent to the technique of ET.

RESULT(S):

There were 117 (41%) responses; 32% practice in academic settings and 68% in private practice. Responders were experienced clinicians, half of whom had performed <10 procedures during training. Ninety-eight percent of practices allowed all practitioners to perform ET; half did not follow a standardized ET technique. Multiple steps in the ET process were identified as "highly conserved;" others demonstrated discordance. ET technique is divided among [1] trial transfer followed immediately with ET (40%); [2] afterload transfer (30%); and [3] direct transfer without prior trial or afterload (27%). Embryos are discharged in the upper (66%) and middle thirds (29%) of the endometrial cavity and not closer than 1-1.5 cm from fundus (87%). Details of each step were reported and allowed the development of a "common" practice ET procedure.

CONCLUSION(S):

ET training and practices vary widely. Improved training and standardization based on outcomes data and best practices are warranted. A common practice procedure is suggested for validation by a systematic literature review.

KEYWORDS:

Embryo transfer; in vitro fertilization; survey

[Indexed for MEDLINE]

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