胚胎植入管距子宮頂1.5cm比距子宮頂1cm之胚胎著床率更高

胚胎植入管距子宮頂(fundus)1.5-2cm 可能比距子宮頂1cm之胚胎著床率或試管懷孕率更高

http://humrep.oxfordjournals.org/content/17/2/341.full

Abstract

BACKGROUND: Traditionally, embryo transfer after IVF has been performed blindly and placing the embryos ~1 cm below the fundal endometrial surface. However, it has been suggested that transferring embryos rather lower in the uterine cavity or high in the uterus may improve implantation rates. Nevertheless, there has not yet been a controlled trial to prove this theory. This prospective randomized study investigates the influence of the depth of embryo replacement on the implantation rate after embryo transfer carried out under transabdominal ultrasound guidance. METHODS: A total of 180 consecutive patients undergoing ultrasound-guided embryo transfer were randomized to three study groups according to the distance between the tip of the catheter and the uterine fundus at the moment of the embryo deposition in the lumen of the endometrial cavity: group 1: 10 ± 1.5 mm; group 2: 15 ± 1.5 mm; group 3: 20 ± 1.5 mm. RESULTS: There was equal distribution between all three study groups regarding the main demographic and baseline characteristics of the patients, ovarian response, oocyte retrieval and IVF outcome, as well as the characteristics of embryo transfer and luteal phase support. The position of the catheter tip in relation to the fundal endometrial surface in groups 1 (10.2 ± 0.9 mm), 2 (14.6 ± 0.7 mm) and 3 (19.3 ± 0.8 mm) was significantly different. Implantation rate was significantly higher (P < 0.05) in groups 2 (31.3%) and 3 (33.3%) compared with group 1 (20.6%). CONCLUSIONS: The depth of the embryo replacement into the uterine cavity may influence implantation rates, and thus it should be considered as an additional procedure among factors recently proposed as associated with successful embryo transfer after IVF.

The influence of the depth of embryo replacement into the uterine cavity on implantation rates after IVF: a controlled, ultrasound-guided study

Table IV.

Implantation and pregnancy rates and outcome of gestation in the three groups studied

Variable	Group 1	Group 2	Group 3
	(n = 61)	(n = 59)	(n = 60)
Values are n (%).
a,b,cValues in rows with common superscripts were significantly different
(P < 0.05).
Clinical pregnancies/embryo transfer	24 (39.3)a	29 (49.2)	36 (60)a
Single	17 (70.8)	15 (51.7)	25 (69.4)
Twins	6 (25)	11 (37.9)	11 (30.5)
Triplets	1 (4.1)	3 (10.3)	1 (2.7)
Implantation rate	20.6b,c	31.3b	33.3c
Spontaneous miscarriage	3 (12.5)	3 (10.4)	4 (11.1)
Ectopic pregnancy