Intrasitoplazmik Sperm Enjeksiyonu Sikluslarında Embriyo Transferinin Abdominal Ultrasonografi Kılavuzluğunda veya Ultrasonografi Kullanılmadan Yapılmasının Klinik Sonuçlarının Değerlendirilmesi

Yıl 2018, Cilt: 44 Sayı: 2, 89 - 94, 01.08.2018

İşıl Kasapoğlu , Furkan Şen Esra Şen , Berrin Avcı , Gürkan Uncu

https://doi.org/10.32708/uutfd.416732

Öz

Yardımlı
üreme yöntemlerinde ovaryan stimülasyon ve embriyo kültüründeki büyük
ilerlemelere rağmen embriyo transfer (ET) tekniklerindeki ilerlemeler sınırlı
kalmıştır veoptimal ET tekniği konusunda fikir birliği bulunmamaktadır.
Retrospektif olarak yürüttüğümüz çalışmamızda ET sırasında abdominal ultrasonografi
kullanılmasının, ultrasonografi kullanılmadan klinik dokunma yöntemi ile ET
yapılan olguların implantasyon ve klinik gebelik oranlarının karşılaştırılması
hedeflenmiştir. Beşinci günde iyi kalitede tek embriyo transferleri
transabdominal ultrasonografi ile (grup 1, n=47) ve klinik dokunma yöntemi ile
yapılan (grup 2, n=46) hastaların implantasyon ve klinik gebelik oranları
karşılaştırıldı. Sonuçta gruplar arasında implantasyon oranları için anlamlı
farklılık izlenmedi (sırası ile grup 1 de %42.6 ve grup 2 de  %34.8, p=0,44). Klinik gebelik oranları
sırası ile grup 1 de %36.2 ve grup 2 de %26.1 idi (p=0,29). Transfer sonrası
transvajinal ultrasonografi ile kontrol edilen hava kabarcığının fundusa olan
mesafeleri karşılaştırıldığında; iki grup arasında anlamlı fark gözlenmedi grup
1 ve 2 de sırasıyla; 13,4 ± 4,23 ve 14,4 ± 3,91 (p=0,25).

Anahtar Kelimeler

Intrasitoplazmik sperm enjeksiyonu, embriyo transferi tekniği, transabdominal ultrasonografi, implantasyon

Evaluation of The Clinical Outcomes of Embryo Transfer in Intracytoplasmic Sperm Injection Cycles with Guidance of Abdominal Ultrasonography or without Using Ultrasonography

Öz

Kaynakça

• 1. Blake DA, Farquhar CM, Johnson N, Proctor M. Cleavage stage versus blastocyststage embryo transfer in assisted conception. Cochrane Database Syst Rev 2007:CD002118.
• 2. Lessey BA. Assessment of endometrial receptivity. Fertil steril 2011; 96: 522–9.
• 3. Polanski LT, Barbosa MA, Martins WP, et al. Interventions to improve reproductive outcomes in women with elevated natural killer cells undergoing assisted reproduction techniques: a systematic review of literature. Hum Reprod 2014; 29: 65–75.
• 4. Phillips JA, MartinsWP, Nastri CO,Raine-Fenning NJ.Difficult embryo transfers or blood on catheter and assisted reproductive outcomes: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2013; 168: 121–8.
• 5. Achache H, Revel A. Endometrial receptivity markers, the journey to successfulembryo implantation. Hum Reprod Update 2006;12:731–46.
• 6. Teixeira DM, Dassuncao LA, Vieira CV, et al. Ultrasound guidance during embryo transfer: a systematic review and meta-analysis of randomized controlled trials. Ultrasound Obstet Gynecol 2015;45:139–48.
• 7. Fanchin R, Righini C, Olivennes F, Taylor S, de Ziegler D, Frydman R. Uterinecontractions at the time of embryo transfer alter pregnancy rates after invitrofertilization. Hum Reprod 1998;13:1968–74.
• 8. Mansour R, Aboulghar M. Optimizing the embryo transfer technique. Hum Reprod 2002;17:1149–53.
• 9. Alvero R, Hearns-Stokes RM, Catherino WH, Leondires MP, Segars JH. The presence of blood in the transfer catheter negatively influences outcome at embryo transfer. Hum Reprod 2003; 18: 1848–52.
• 10. Van Weering HG, Schats R, McDonnell J, Vink JM, Vermeiden JP, Hompes PG. The impact of the embryo transfer catheter on the pregnancy rate in IVF. Hum Reprod 2002; 17: 666–70.
• 11. Knutzen V, Stratton CJ, Sher G, McNamee PI, Huang TT, Soto-Albors C. Mock embryo transfer in early luteal phase, the cycle before in vitro fertilization and embryo transfer: a descriptive study. Fertil Steril 1992; 57: 156–62.
• 12. Li B, Zhou H, Li W. Bed rest after embryo transfer. Eur J Obstet Gynecol Reprod Biol 2011; 155: 125–8.
• 13. Brown J, Buckingham K, Abou-Setta AM, Buckett W. Ultrasound versus ‘clinical touch’ for catheter guidance during embryo transfer in women. Cochrane Database Syst Rev 2010:CD006107.
• 14. Lorusso F, Depalo R, Bettocchi S, Vacca M, Vimercati A, Selvaggi L. Outcome of in vitro fertilization after transabdominal ultrasound-assisted embryo transfer with a full or empty bladder. Fertil Steril 2005; 84: 1046–8.
• 15. De Camargo Martins AM, Baruffi RL, Mauri AL,et al. Ultrasound guidance is not necessary during easy embryo transfers. J Assist Reprod Genet 2004; 21: 421–5.
• 16. Woolcott R, Stanger J: Potentially important variables identified by transvaginal ultrasound-guided embryo transfer. Hum Reprod 1997;12:963–6.
• 17. Kan A, Abadalla H, Gafar A: Embryo transfer: Ultrasoundguided versus clinical touch. Hum Reprod 1999;14:1259– 61.
• 18. Racowsky C, Vernon M, Mayer J, et al. Standardization of grading embryo morphology. J Assist Reprod Genet 2010;27: 437–9.
• 19. Lesny, P., Killick, S.R., Tetlow, R.L., Robinson, J. and Maguiness, S.D. (1998) Embryo transfer can we learn anything new from the observation of junctional zone contractions? Hum. Reprod., 13, 1540-6.
• 20. Abou-Setta AM. What is the best site for embryo deposition? A systematic review and meta-analysis using direct and adjusted indirect comparisons. Reprod Biomed Online 2007;14:611–9.
• 21. Pope CD, Cook EK, Arny M, Novak A, Grow DR. Influence of embryo transfer depth on in vitrofertilization and embryo transfer outcomes. Fertil Steril 2004;81:51-8
• 22. Nazari A, AskariHA, Check JH, O’Shaughnessy A. Embryo transfer technique as a cause of ectopic pregnancy in in vitro fertilization. Fertil Steril 1993;60:919-21.
• 23. Kovacs P, Sajgo A, Rarosi F, Kaali SG. Does it really matter how far from the fundus embryos are transferred? Eur J Obstet Gynecol Reprod Biol 2012, 162: 62-6.
• 24. Baba K, Ishihara O, Hayashi N, Saitoh M, Taya J, Kinoshita K. Where does theembryo implant after embryo transfer in humans. Fertil Steril 2000;73:123–5.
• 25. Confino E, Zhang J, Risquez F. Air bubble migration is a random event postembryo transfer. J Assist Reprod Genet 2007;24:223–6.
• 26. Woolcott R, Stanger J. Potentially important variables identified by transvaginal ultrasound-guided embryo transfer, Hum Reprod 1997;12(5):963-6.
• 27. Anice Maria Vieira de Camargo Martins, Ricardo L. R. Baruffi, Ana L. Mauri, et al. Ultrasound Guidance Is Not Necessary During Easy Embryo Transfers. Journal of Assisted Reproduction and Genetics 2004; 21(12): 421–5.
• 28. Coroleu, B., Barri, P.N., Carreras, O., Martinez, F., 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, 341-6.29. Al-Shawaf T, Dave R, Harper J, Linehan D, Riley P, Craft I: Transfer of embryos into the uterus: how much do technical factors affect pregnancy rates? J Assist Reprod Genet 1993;10:31– 6.
• 30. Woolcott R, Stanger J: Ultrasound tracking of the movement of embryo-associated air bubbles on standing after transfer. Hum Reprod 1998;13:2107–9.
• 31. Brown J, Buckingham K, Abou-Setta AM, Buckett W. Ultrasound versus ‘clinicaltouch’ for catheter guidance during embryo transfer in women. Cochrane Database Syst Rev 2016.
• 32. Bodri D, Colodr_on M, García D, Obradors A, Vernaeve V, Coll O. Transvaginal versus transabdominal ultrasound guidance for embryo transfer in donor oocyte recipients: a randomized clinical trial. Fertil Steril 2011;95:2263–8.
• 33. Paladini D. Sonography in obese and overweight pregnant women: clinical, medicolegal and technical issues. Ultrasound Obstet Gynecol 2009; 33:720–9.