Chapter 29 - Ultrasonography-guided embryo transfer:

Summary

Meticulous embryo transfer (ET) should ensure proper delivery of embryos inside the uterine cavity. This depends on several factors, including uterocervical angle, length of cervical canal, and how far the ET catheter is advanced. When a problematic cervix is identified, a plan of action needs to be formulated. Currently most practitioners perform ET under ultrasound guidance. This helps in making the ET procedure easy and atraumatic and, in turn, optimizes the chances of a successful transfer. Woolcott and Stanger have demonstrated suboptimal placement of the catheter tip in approximately 50% of patients when transvaginal ultrasound-guided ET was performed. Cervical lavage before ET should be done under ultrasound guidance, which ensures complete removal of cervical mucus and avoidance of pushing of washing medium into the endometrial cavity. New technology from General Electric (GE) allows ultrasonography-guided ET using a 4D mode, with significant advantage in the transfer process.