POTENTIALLY IMPORTANT VARIABLES IDENTIFIED BY TRANSVAGINAL ULTRASOUND-GUIDED EMBRYO-TRANSFER

Transvaginal ultrasound-guided embryo transfer was performed on 121 co nsecutive patients, Observation was made of guiding cannula and transf er catheter placement in relation to the endometrial surface and uteri ne fundus during embryo transfer. The position and movement of a trans fer-associated air bubble and the impact of subendometrial myometrial contraction leading to endometrial movement was observed. Results indi cate that tactile assessment of embryo transfer catheter placement is unreliable: in 17.4% of transfers the outer guiding catheter inadverte ntly abutted the fundal endometrium. The outer guiding cannula indente d the endometrium in 24.8% and the transfer catheter embedded in the e ndometrium in 33.1%. Unavoidable sub-endometrial transfers occurred in 22.3% of transfers. Ultrasound-guided transfer avoided accidental tub al transfer in 7.4% of transfers, Transfer catheter withdrawal did not significantly affect embryo transfer-associated air bubble position. Endometrial movement due to sub-endometrial myometrial contraction was obvious in 36.4% of cases,,vith active motion of the transfer-associa ted air bubble occurring in 28.1%. Pregnancies occurred in 45.5% of tr ansfers with endometrial movement compared to 15.6% (P < 0.001) withou t.