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

Autor:	Toth TL; Vincent Reproductive Medicine and IVF, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: TLTOTH@partners.org., Lee MS; Vincent Reproductive Medicine and IVF, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts., Bendikson KA; USC Fertility, University of Southern California, Los Angeles, California., Reindollar RH; University of Alabama, Birmingham, Alabama.
Jazyk:	angličtina
Zdroj:	Fertility and sterility [Fertil Steril] 2017 Apr; Vol. 107 (4), pp. 1003-1011.
DOI:	10.1016/j.fertnstert.2016.10.040
Abstrakt:	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. (Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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