Ultrasound guidance during embryo transfer: a prospective, single-operator, randomized, controlled trial.

OBJECTIVE

To determine whether the implementation of ultrasound (US) guidance will improve the clinical outcomes of ET compared with the standard clinical touch method of embryo catheter placement.

DESIGN

Prospective, single-operator, randomized, controlled trial.

SETTING

Saudi Center for Assisted Reproduction.

PATIENT(S): Three hundred seventy-three women.

INTERVENTION(S): Transcervical, intrauterine ET with or without US guidance.

MAIN OUTCOME MEASURE(S): Primary outcomes were the live-birth/ongoing pregnancy and clinical pregnancy rates per randomized woman. Secondary outcomes were the incidences of difficult transfers, blood and/or mucus on the catheter tip, spontaneous miscarriages, and ectopic pregnancies.

RESULT(S): Demographics and cycle characteristics were not different between the two groups. The live-birth/ongoing pregnancy rate was significantly higher in the US ET group (68 of 183, 40.98%) than in the clinical touch ET group (50 of 190, 28.42%) (odds ratio = 1.66, 95% confidence interval 1.07-2.57). In addition, there was a significantly higher number of clinical pregnancies in the US ET group (75 of 183, 40.98%) than in the clinical touch ET group (54 of 190, 28.42%) (odds ratio = 1.75, 95% confidence interval 1.14-2.69). Secondary outcomes were not significantly different between the two groups.

CONCLUSION(S): Ultrasound-guided ET significantly increases ongoing pregnancy/live-birth and clinical pregnancy rates compared with the clinical touch method.