Embryo transfer techniques: an American Society for Reproductive Medicine survey of current Society for Assisted Reproductive Technology practices

Document Type

Journal Article

Publication Date

4-1-2017

Journal

Fertility and Sterility

Volume

107

Issue

4

DOI

10.1016/j.fertnstert.2016.10.040

Keywords

Embryo transfer; in vitro fertilization; survey

Abstract

© 2017 American Society for Reproductive Medicine Objective To better understand practice patterns and opportunities for standardization of ET. Design Cross-sectional survey. Setting Not applicable. Patient(s) Not applicable. Intervention(s) An anonymous 82-question survey was emailed to the medical directors of 286 Society for Assisted Reproductive Technology member IVF practices. A follow-up survey composed of three questions specific to ET technique was emailed to the same medical directors. Descriptive statistics of the results were compiled. Main Outcome Measure(s) The survey assessed policies, protocols, restrictions, and specifics pertinent to the technique of ET. Result(s) There were 117 (41%) responses; 32% practice in academic settings and 68% in private practice. Responders were experienced clinicians, half of whom had performed <10 procedures during training. Ninety-eight percent of practices allowed all practitioners to perform ET; half did not follow a standardized ET technique. Multiple steps in the ET process were identified as “highly conserved;” others demonstrated discordance. ET technique is divided among [1] trial transfer followed immediately with ET (40%); [2] afterload transfer (30%); and [3] direct transfer without prior trial or afterload (27%). Embryos are discharged in the upper (66%) and middle thirds (29%) of the endometrial cavity and not closer than 1–1.5 cm from fundus (87%). Details of each step were reported and allowed the development of a “common” practice ET procedure. Conclusion(s) ET training and practices vary widely. Improved training and standardization based on outcomes data and best practices are warranted. A common practice procedure is suggested for validation by a systematic literature review.

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