Embryo transfer: ultrasound-guided versus clinical touch

In this prospective control study, the pregnancy and implantation rates wer e compared between ultrasound-guided and clinical touch uterine embryo tran sfers. In addition, a subset of patients was sought that would particularly benefit from embryo transfer under ultrasound guidance, A total of 187 pat ients (93 ultrasound and 94 clinical touch) was enrolled. Allocation was ra ndom and depended on whether their embryo transfers were done during the 1 h each day in which the ultrasound was available, Pregnancy and implantatio n rates of 37.8 and 20.4% respectively were achieved when ultrasound was us ed, compared with 28.9 and 16.2% respectively with clinical touch. This dif ference was not statistically significant. There was no significant differe nce in the pregnancy rate when the number of embryos transferred was contro lled. Older women (greater than or equal to 37 years old) had an apparently higher pregnancy rate (38.1 versus 20.4%; not significant) with ultrasound guidance during embryo transfer. In the subgroup where the clinician rated the transfer procedure as difficult, there appeared to be a substantial im provement in the pregnancy rate in the group that used ultrasound (54.5 ver sus 10.0%; not significant). Although our results were not statistically si gnificant, we believe that ultrasound-guided embryo transfers should be use d in clinically difficult embryo transfers and in older women, as it appear s to improve the pregnancy rate over clinical touch transfers.