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54 - Optimizing Embryo Transfer
from PART III - ASSISTED REPRODUCTION
- By Hassan N. Sallam
Edited by Botros R. M. B. Rizk, University of South Alabama, Juan A. Garcia-Velasco, Hassan N. Sallam, Antonis Makrigiannakis, University of Crete
Book:

Infertility and Assisted Reproduction

Published online:

04 August 2010

Print publication:

15 September 2008, pp 506-517
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Summary

This chapter describes the technique of embryo transfer (ET) to evaluate the various modifications proposed in order to maximize the chances of pregnancy, and discusses the different approaches available for managing difficult ETs. Before embarking on an ET, the following factors should be considered: embryo selection, choice of the catheter, performing a trial (mock or dummy) ET, ET medium, ultrasound, flushing the cervical mucus before performing ET. Randomized trials have shown that ultrasound guidance and the use of soft catheters as opposed to firm catheters are associated with higher pregnancy rates. They have also shown that the presence of air in the catheter, its immediate removal, bed rest after ET, sexual intercourse, and the administration of aspirin after ET do not affect the results. Routine use of antibiotics, uterine relaxants, and medication to increase uterine blood flow await further evaluation.