Performing The Embryo Transfer

There is good evidence based on 10 RCTs to recommend TA ultrasound guidance during embryo transfer to improve clinical pregnancy rate and live-birth rate. (, A)

Embryo transfer is considered a critical step in the IVF process. Extensive literature exists regarding all aspects of embryo transfer, which supports its importance to overall IVF success. While there are insufficient data to provide guidance on a number of techniques used during embryo transfer, the literature does provide guidance for many aspects of this critical component of IVF.
The following interventions are supported by the literature for improving pregnancy rates:

• Abdominal ultrasound guidance for embryo transfer
• Removal of cervical mucus
• Use of soft embryo transfer catheters
• Placement of embryo transfer tip in the upper or middle (central) area of the uterine cavity, greater than 1 cm from the fundus, for embryo expulsion
• Immediate ambulation once the embryo transfer procedure is completed

The following interventions have been shown not to be beneficial for improving pregnancy rates:

• Acupuncture
• Analgesics, massage, general anesthesia, whole systems–traditional Chinese medicine
• Prophylactic antibiotics to improve embryo transfer outcomes
• Waiting after expulsion of embryos for any specific period of time before withdrawing the embryo transfer catheter

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