A meta-analysis of ultrasound-guided versus clinical touch embryo transfer

Objective: To determine the relative efficacy of ultrasound-guided embryo transfer and embryo transfer by clinical touch alone. Design: Systematic review and meta-analysis of randomized, controlled trials comparing ultrasound-guided embryo transfer with embryo transfer by clinical touch alone. Setting: Infertility centers providing treatment with in vitro fertilization/embryo transfer. Patient(s): Women undergoing embryo transfer. Intervention(s): Embryo transfer with or without transabdominal ultrasound guidance. Main Outcome Measure(s): Clinical pregnancy rate and embryo implantation rate. Result(s): A total of eight prospective controlled trials were identified. Of these studies, four were nonrandomized or quasi-randomized and four were genuinely randomized. Meta-analysis demonstrated a significantly increased chance of clinical pregnancy following ultrasound-guided embryo transfer in all studies and in the genuinely randomized subgroup. The embryo implantation rate was also significantly increased following ultrasound-guided embryo transfer. Conclusion(s): Ultrasound-guided embryo transfer significantly increases the chance of clinical pregnancy and significantly increases the embryo implantation rate. ((C)2003 by American Society for Reproductive Medicine).