Ultrasound-guided soft catheter embryo transfers will improve pregnancy rates in in-vitro fertilization

Attempts to improve clinical pregnancy rates after in-vitro fertilization ( IVF) and embryo transfer are constantly being made. Two changes in techniqu e of embryo transfer of potential clinical importance were evaluated over t wo contiguous time periods in order to observe any corresponding change in clinical pregnancy (CP) rate per transfer: (i) embryo transfer catheter; (i i) ultrasound guidance. Catheter choices mere hard: Tefcat, Tom Cat, or Nor folk; or soft: Frydman or Wallace. Ultrasound visualization was considered to be excellent/good when the catheter could be followed from the cervix to the fundus by transabdominal ultrasound with retention of the embryo-conta ining fluid droplet; fair/poor if visualization could not document the sequ ence of events. Embryo transfers were performed in 518 cycles. CP rates per transfer using soft and hard catheters was 36 and 17% (P < 0.000) respecti vely. CP rates per transfer for transfers performed with and without ultras ound guidance were 38 and 25% (P < 0.002) respectively. A statistically sig nificant difference was also noted when visualization ranks were compared. CP rates per transfer in all excellent/good ultrasound-guided transfers was 41.5 versus 16.7% for fair/poor transfers (P < 0.038). In conclusion, perf ormance of embryo transfer with a soft catheter under ultrasound guidance w ith good visualization resulted in a significant increase in clinical pregn ancy rates.