Sonographer‐guided frozen embryo transfer vs ultrasound‐assisted frozen embryo transfer – A randomised controlled study

Abstract

BackgroundThe use of ultrasound to guide placement of the embryo during in vitro fertilisation (IVF) is important, but there are times where a good image cannot be obtained. Having a trained sonographer perform the ultrasound may therefore improve the success of embryo transfer.AimTo determine whether the routine use of a sonographer to guide embryo transfer is superior to standard care.Materials and MethodsRandomised, controlled, prospective clinical study in a private infertility clinic. There were 113 women aged <38 years undergoing frozen embryo transfer (donor egg/embryo excluded) who were randomised to sonographer‐guided embryo transfer or standard care (the doctor performs an ultrasound prior to embryo transfer and the patient holds the ultrasound probe). The primary outcome was visualisation of the air bubble, and secondary outcomes were distance of the air bubble from the fundal endometrium, pregnancy rate (gestational sac on ultrasound at seven weeks) and live birth rate.ResultsThe bubble was visualised in 100% of embryo transfers with a sonographer compared to 83% in the ultrasound‐assisted group, and this was statistically significant (P < 0.01). No statistically significant differences were found in terms of distance from the fundal endometrium or in pregnancy rate and live birth rate.ConclusionSonographer‐guided embryo transfer leads to statistically higher rates of visualisation of the air bubble compared to ultrasound‐assisted transfer.