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

ObjectiveTo 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.DesignProspective, single-operator, randomized, controlled trial.SettingSaudi 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.