Research Article
EMBRYO VE FUNDAL ENDOMETRİAL YÜZEY ARASINDAKİ MESAFENİN İNTRA SİTOPLAZMİK SPERM İNJEKSİYONU SİKLUSLARINDA SONUÇLARA ETKİSİ The Effect of the Distance Between Embryo and Fundal Endometrial Surface on the Success of Intracytoplasmic Sperm Injection Cycles
Abstract
ÖZET
Amaç: Çalışmadaki amacımız, intrastoplazmik sperm injeksiyonu (İCSİ) sikluslarında embryo transferi sırasında
ölçülen embryo ile fundal endometrial yüzey arası mesafenin (EFM) implantasyon, klinik gebelik, eve
bebek götürme ve abort oranlarına etkisini araştırmaktır.
Gereç ve Yöntem: Taze non-donor İCSİ siklusuna alınan ve embryo transferi (ET) gerçekleştirilen 176 hasta
retrospektif olarak çalışmaya alındı. 3 damla tekniği ile Wallace katetere yüklenen embryo/embriyolar
transabdominal ultrason eşliğinde transfer edildi ve transfer sırasında EFM ölçüldü. Hastalar EFM’e göre
≤15 mm, 15-20 mm, ≥20 mm olarak 3 gruba kategorize edildi. ET’den 14 gün sonra bakılan gebelik testinin
pozitif olması ‘implantasyon’, transvaginal ultrasonda gestasyonel kese görülmesi ‘klinik gebelik’ ve viabl
canlı bebek doğumu ‘eve bebek götürme’ olarak kabul edildi. <20. gebelik haftasından önce olan gebelik
kayıpları ‘abort’ olarak değerlendirildi.
Bulgular: En yüksek implantasyon ve klinik gebelik, EFM≥20 mm olan grupta izlenmesine rağmen eve bebek
götürme oranı EFM≤15 mm olan grupta diğerlerine göre daha yüksekti. Abort, en yüksek EFM≥20mm
olan grupta izlendi. İmplantasyon, klinik gebelik, eve bebek götürme ve abort açısından gruplar arasında
anlamlı fark izlenmedi. Grupların hiç birinde ektopik gebeliğe rastlanmadı. Klinik olarak gebe kalan grupta
toplanan oosit sayısı, matafaz II sayısı ve embryo sayısı gebe kalmayan gruba göre anlamlı olarak yüksekti.
Klinik gebelik oluşumu, EFM tarafından etkilenmiyordu. Gebelik başarısını etkilediği bilinen değişkenler
kofaktör olarak alındığında da EFM implantasyon, klinik gebelik ve eve bebek götürme oranını etkilememekteydi.
Sonuç: EFM, İCSİ sikluslarında klinik sonuçları anlamlı olarak etkilemiyor gibi görünse de EFM≤15 mm olması
viabl bebek doğum şansını arttırıp İCSİ başarısını arttırır. Optimum EFM aralığını bulmak için büyük hasta
katılımlı randomize kontrollu klinik çalışmalara ihtiyaç vardır.
Anahtar Sözcükler: Embryo fundus mesafesi; İntra sitoplazmik sperm injeksiyonu; İmplantasyon; Gebelik;
abort.
ABSTRACT
Purpose: To investigate the effect of the distance between embryo and fundal endometrial surface (EFD)
on implantation, clinical pregnancy (CP), take home baby and abortion rates among intracytoplasmic
sperm injection (ICSI) cycles.
Material and Methods: This was a retrospective clinical trial including 176 primer infertile women
undergoing embryo transfer (ET) following fresh non–donor ICSI cycle. Embryo/embryos were transferred
by Wallace catheter via three-drop technique under transabdominal ultrasound and EFD was measured.
The participants were divided into three groups on the basis of EFD: ≤15 mm, 15-20 mm, and ≥20 mm.
‘Implantation’ was defined as positive pregnancy test following ET, ‘CP’ was described as the presence of a
gestational sac in transvaginal ultrasonographic examination and ‘take home baby’ was described as having
a living infant. Pregnancy loss before 20 gestational week was accepted as ‘abortion’.
Results: Implantation and CP were higher in EFM≥20 mm group, however, take home baby rates were
higher in EFD≤15 mm group compared the others. Abortion was more prevelant in EFD≥20mm group.
Implantation, CP, take home baby and abortion rates were comparable among three groups. There were
no ectopic pregnancies in any groups. Pregnant and non-pregnant groups were significantly different
from each other with regard to total oocyte count, metaphase II count, embryo count. In women who
conceived, aforementioned parameters were significantly higher compared to women who didn’t
conceived. Implantation, CP and take home baby rates were not affected by EFD even variables which were
known to affect ICSI success were taken as cofactors with EFD.
Discussion: EFD does not affect clinical success of ICSI cycles, however, take home baby rates appeared to
be higher in cases with EFD≤15 mm. Further well-designed randomized clinical controlled trials with large
sample-sized are needed to optimize EFD.
Keywords: Embryo fundus distance; İntra cytoplasmic sperm injection; İmplantation, pregnancy, abortion.
References
- Tiras B, Polat M, Korucuoglu U, Zeyneloglu HB, Yarali H. Impact of embryo replacement depth on in vitro fertilization and embryo transfer outcomes. Fertil Steril. 2010;94(4):1341-5. 2. Friedman BE, Lathi RB, Henne MB, Fisher SL, Milki AA. The effect of air bubble position after blastocyst transfer on pregnancy rates in IVF cycles. Fertil Steril. 2011;95(3):944-7. 3. Schoolcraft WB, Surrey ES, Gardner DK. Embryo transfer: techniques and variables affecting success. Fertil Steril. 2001;76(5):863-70. 4. Kovacs GT. What factors are important for successful embryo transfer after in-vitro fertilization? Hum Reprod. 1999;14(3):590-2. Bozok Tıp Derg 2018;8(1):1-10 Bozok Med J 2018;8(1):1-10 TOLA ve ark. Embryo Fundus Mesafesinin İCSİ Sonuçlarına Etkisi 10 5. Mains L, Van Voorhis BJ. Optimizing the technique of embryo transfer. Fertil Steril. 2010;94(3):785-90. 6. Coroleu B, Barri PN, Carreras O, Martinez F, Parriego M, Hereter L, et al. The influence of the depth of embryo replacement into the uterine cavity on implantation rates after IVF: a controlled, ultrasound-guided study. Hum Reprod. 2002;17(2):341-6. 7. Lambers MJ, Dogan E, Lens JW, Schats R, Hompes PG. The position of transferred air bubbles after embryo transfer is related to pregnancy rate. Fertil Steril. 2007;88(1):68-73. 8. Pope CS, Cook EK, Arny M, Novak A, Grow DR. Influence of embryo transfer depth on in vitro fertilization and embryo transfer outcomes. Fertil Steril. 2004;81(1):51-8. 9. Frankfurter D, Trimarchi JB, Silva CP, Keefe
Year 2018,
Volume: 8 Issue: 2, 1 - 10, 29.06.2018
Abstract
References
- Tiras B, Polat M, Korucuoglu U, Zeyneloglu HB, Yarali H. Impact of embryo replacement depth on in vitro fertilization and embryo transfer outcomes. Fertil Steril. 2010;94(4):1341-5. 2. Friedman BE, Lathi RB, Henne MB, Fisher SL, Milki AA. The effect of air bubble position after blastocyst transfer on pregnancy rates in IVF cycles. Fertil Steril. 2011;95(3):944-7. 3. Schoolcraft WB, Surrey ES, Gardner DK. Embryo transfer: techniques and variables affecting success. Fertil Steril. 2001;76(5):863-70. 4. Kovacs GT. What factors are important for successful embryo transfer after in-vitro fertilization? Hum Reprod. 1999;14(3):590-2. Bozok Tıp Derg 2018;8(1):1-10 Bozok Med J 2018;8(1):1-10 TOLA ve ark. Embryo Fundus Mesafesinin İCSİ Sonuçlarına Etkisi 10 5. Mains L, Van Voorhis BJ. Optimizing the technique of embryo transfer. Fertil Steril. 2010;94(3):785-90. 6. Coroleu B, Barri PN, Carreras O, Martinez F, Parriego M, Hereter L, et al. The influence of the depth of embryo replacement into the uterine cavity on implantation rates after IVF: a controlled, ultrasound-guided study. Hum Reprod. 2002;17(2):341-6. 7. Lambers MJ, Dogan E, Lens JW, Schats R, Hompes PG. The position of transferred air bubbles after embryo transfer is related to pregnancy rate. Fertil Steril. 2007;88(1):68-73. 8. Pope CS, Cook EK, Arny M, Novak A, Grow DR. Influence of embryo transfer depth on in vitro fertilization and embryo transfer outcomes. Fertil Steril. 2004;81(1):51-8. 9. Frankfurter D, Trimarchi JB, Silva CP, Keefe
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Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Original Research |
| Authors | |
| Publication Date | June 29, 2018 |
| Published in Issue | Year 2018 Volume: 8 Issue: 2 |
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