Training of providers in embryo transfer: what is the minimum number of transfers required for proficiency?

BACKGROUND: Embryo transfer represents one of the most critical procedures in the practice of assisted reproduction. The objective of this study was t o identify retrospectively the minimum number of embryo transfers required to train providers properly in this skill. METHODS AND RESULTS: The study g roup consisted of 204 patients who received embryo transfers between Januar y 1996 and March 2000 in a university-based programme of assisted reproduct ion. The main outcome measure was clinical pregnancies per embryo transfer. Five Fellow trainees performed a total of 204 embryo transfers for an over all pregnancy rate of 45.5% per embryo transfer (93/204), In comparison, th e programme pregnancy rate per transfer for experienced providers was 47.3% (560/1179). A chronological graph of each individual trainee's experience for the first 50 embryo transfers performed suggested a lower initial pregn ancy rate for three of the five trainees, To determine whether a learning c urve might exist, results of the first 25 transfers were compared as a subg roup with the second 25 transfers. Pregnancy rates were lower for the 1-25 transfer subgroup than in the 26-50 subgroup for three of the five Fellow t rainees, although the difference was not statistically significant. CONCLUS ION: Clinical pregnancy rates of Fellows-in-training were indistinguishable statistically from those of experienced staff by 50 transfers.