Impact of embryo replacement depth on in vitro fertilization and embryo transfer outcomes

Fertil Steril. 2010 Sep;94(4):1341-1345. doi: 10.1016/j.fertnstert.2009.07.1666. Epub 2009 Dec 30.


Objective: To investigate the impact of embryo replacement depth on IVF and embryo transfer outcomes.

Design: Retrospective analysis (May 2005 to November 2008) of 5,055 ultrasound-guided embryo transfers belonging to 3,930 infertile couples. The distance between the fundal endometrial surface and the catheter tip was measured and accordingly, patients were divided into five groups.

Setting: Anatolia IVF Center, Ankara, Turkey.

Patient(s): All patients enrolled in the IVF program undergoing embryo transfer.

Intervention(s): No patient received any additional procedure or intervention.

Main outcome measure(s): Clinical pregnancy rate (PR) and ongoing PR.

Result(s): Mean total number of embryos transferred in groups 4 and 5 were significantly higher than in groups 2 and 3. Analysis of PRs and outcome of gestations in the five groups studied yielded similar PRs in all groups except for group 1.

Conclusion(s): Pregnancy rates and ongoing PRs are higher if the embryos are replaced at a distance >10 mm from the fundal endometrial surface. In addition because significantly more embryos were replaced in cycles where the transfers occurred at a distance of >20 mm, a distance>10 mm to <20 mm seems to be the best site for embryo transfer to achieve higher PRs.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Embryo Transfer / instrumentation
  • Embryo Transfer / methods*
  • Female
  • Fertilization in Vitro* / methods
  • Humans
  • Infertility / diagnostic imaging
  • Infertility / pathology
  • Infertility / therapy
  • Male
  • Oocyte Retrieval / methods
  • Ovulation Induction / methods
  • Pregnancy
  • Retrospective Studies
  • Treatment Outcome
  • Ultrasonography, Interventional / instrumentation
  • Ultrasonography, Interventional / methods*
  • Uterus / diagnostic imaging
  • Uterus / pathology*
  • Young Adult