Tuesday, June 11, 2013

Dr Malpani's guide to the embryo transfer procedure - what every infertile patient needs to know



Infertile patients have many questions that create doubt and misunderstanding when it comes to the embryo transfer procedure.  It is especially when good quality embryos fail to implant after a smooth embryo transfer procedure that patients feel cheated; and complain that the IVF doctor did not provide good medical care.

In this review, I will try to simplify the information and dispel some of these misconceptions.

There are two components to successful embryo transfer.  One is the mechanical procedure of physically placing the embryo back into the uterine cavity which is achieved by inserting an embryo transfer catheter into the uterus through the cervix.  The biological process is that of implantation, but this is not something the doctor can control !

The mechanics of the embryo transfer procedure is fairly straight forward and takes only a few minutes.  The procedure is performed routinely in IVF clinics.  A skillful IVF physician is patient and gentle.  Proper procedure and patience is required to prevent injury to the embryo and the uterus.  A steady hand and gentle, deliberate action is required. 

The simplicity of the procedure can be misleading, however.  Pregnancy rates vary greatly among IVF physicians.  There are documented instances of success rates 3 times higher by some IVF physicians who perform in the same clinic under the same environment as other, less successful co-workers.  We have no clear understanding as to why there is such a marked difference in success rates.  Successful implantation is a quality indicator that should be considered when seeking an IVF physician.  Take the time to search for an experienced physician with a high success rate.

Ultrasound guided transfer is a process that assists the physician with actually visualizing the deposit site of the embryos.  Whether using ultrasound improves implantation with an already successful physician is still controversial and warrants further study.

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