Evaluation of embryo transfer through a scoring system: ETSS (Embryo transfer scoring system)

J Gynecol Obstet Hum Reprod. 2022 Jan;51(1):102237. doi: 10.1016/j.jogoh.2021.102237. Epub 2021 Oct 3.

Abstract

Introduction: To create a scoring system by including all of the factors that are recommended for an ideal ET and to investigate its correlation with the Β-HCG results.

Materials and methods: This study was conducted as a retrospective trial between January 2009 and December 2018. Women who had a single ET between the specified dates were included in the study. The embryo grade, ET day, distance between the fundus to embryo transfer site measured via ultrasonography, endometrial thickness on ET day, and presence of mucus and blood in the catheter after transfer were the variables evaluated. Each one of the five variables that constituted the scoring system were rated separately.

Results: Overall, 1652 patients participated in this research. Antral follicle count (13,3 ± 8 vs. 14,6 ± 8,2, p: 0,001), endometrial thickness on the ET day (9.9 ± 2 vs.10.3 ± 2, p = 0.006) and number of mature oocytes (8.6 ± 6 vs. 9 ± 5.1, p: 0.003) were significantly higher in patients with positive Β-HCG values. The total score in the Β-HCG positive group was 9.8 ± 1.4 versus 8.9 ± 1.4 in the Β-HCG negative group (p < 0.001). The best ETSS cut-off value for predicting Β-HCG positivity was 9.5, with 82% sensitivity and 67% specificity (AUC:0.808).

Conclusion: Our scoring system is an important step toward standardization, as it offers a new, practical, cost-free, and applicable scoring system based on pre- and post-ET measurements and laboratory data.

Keywords: Embryo grade; Embryo transfer; Endometrial thickness; Fundus embryo distance.

MeSH terms

  • Adult
  • Chi-Square Distribution
  • Cohort Studies
  • Embryo Transfer / classification*
  • Embryo Transfer / methods
  • Female
  • Fertilization in Vitro / classification
  • Fertilization in Vitro / methods
  • Humans
  • Research Design / standards*
  • Retrospective Studies
  • Statistics, Nonparametric