Ultrasound guidance of embryo transfer: a role for midwife

Abstract

Objective: Evaluate the role of midwife with no experience in assisting ultrasound guided embryo transfer.

Methods: A prospective randomized study comparing results of IVF after ultrasound guided embryo transfer (ET) assisted either by a midwife with no formal training in US, or by a doctor trained to guide. ET procedure was performed on 553 patients undergoing ultrasound guided ET. The number of embryos transferred, the pregnancy rate (PR), the incidence of extrauterine pregnancy, ongoing pregnancy rate, the implantation rate (IR), difficulty of embryo transfer and quality of US assistance were compared among the groups.

Results: No significant differences were observed between the two groups regarding the number of embryos transferred (2.5+0.7 Group A vs 2.4+0.8 Group B) implantation rate (15.6% Group A vs 15.2% Group B), pregnancy rate (34.3% Group A vs 36.2% Group B), ongoing pregnancy rate (23.4% Group A vs 23.9% Group B), and rate of extrauterine pregnancies (1.4% Group A vs 1% Group B). Difficult transfers (2.9% Group A vs 3.6% Group B) and unsatisfactory visualization of uterus and catheter (6.2% Group A vs 7.3% Group B) were also similar in both groups of patients.

Discussion: Having an inexperienced nurse or midwife to perform ultrasound guidance during ET does not markedly affect the clinical results compared to using experienced clinicians for this purpose.

Keywords: Embryo transfer; In vitro fertilization; Midwife; Ultrasound.