MULTIPLE ATTEMPTS AT EMBRYO TRANSFER - EFFECT ON PREGNANCY OUTCOME INAN INVITRO FERTILIZATION AND EMBRYO TRANSFER PROGRAM

Purpose: This study derives from the observation that a correlation ex ists between failed first attempts (FFA) at embryo transfer caused by one or more embryos remaining in the catheter and reduced pregnancy ra tes (20.3 vs 3.0%). The aim of this study was to examine the relations hip between failed first attempts at transfer and contamination of the transfer set; the related aspects of cervix dilatation and late embry o transfer were also investigated. Results: The following observations were made. Retention of embryos in the transfer sets significantly re duced the pregnancy rate (P = 0.015); catheters contaminated with bloo d and cervical mucus indirectly contributed to this effect by increasi ng the incidence of failed first transfer attempts. Even though cervic al dilatations, if indicated by uterus sounding, were done 2 days befo re embryo transfer, no pregnancies were effected in these 18 cases (P = 0.0001). Late transfers of embryos, due to delayed fertilization or slow cleavage rates, yielded a pregnancy rate of 10.5%. Conclusion: Th e approach of immediately retransferring retained embryos does not sol ve the problem of reduced pregnancy rates in FFA cases. It is suggeste d that ET should be repeated 1 day later in FFA cases in an attempt to improve pregnancy rates.