title: The use of fixed distance embryo transfer after IVF/ICSI equalizes the success rates among physicians.
abstract: BACKGROUND
  It is suggested that the skill of the physician performing the embryo transfer may influence the outcome of the procedure. In this study we investigated the effects of a change in embryo transfer technique on the variability in success rates among physicians.
  
  
  METHODS
  Retrospectively 4439 transfer cycles in which two different embryo transfer techniques were applied by seven physicians were studied. In the first 2210 cycles, transfers were performed using the 'clinical touch' method. In the following 2229 cycles, the so-called fixed distance technique was used.
  
  
  RESULTS
  With the clinical touch method pregnancy rates differed greatly among providers, whereas after the introduction of the fixed distance technique these differences disappeared. Furthermore, the overall clinical pregnancy rate increased from 33.6 to 40.4% per transfer. Using smoothing spline curves we failed to detect a sudden rise in pregnancy rates at the time the transfer method was changed.
  
  
  CONCLUSIONS
  The introduction of the fixed distance technique greatly reduced the variation in pregnancy rates among physicians. The overall increase in pregnancy rates after the introduction is likely to be related to the change in technique although definite proof is difficult. Both observations are suggested to be attributable to the atraumatic character of the fixed distance technique.
authors.affiliation: Division for Reproductive Medicine, Department of Perinatology and Gynecology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
authors.forename: M M C
authors.initials: MM
authors.lastname: van de Pas
authors.forename: S
authors.initials: S
authors.lastname: Weima
authors.forename: C W N
authors.initials: CW
authors.lastname: Looman
authors.forename: F J M
authors.initials: FJ
authors.lastname: Broekmans
mesh_terms: D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D010820:Physicians; D011247:Pregnancy; D018873:Pregnancy Rate; D018456:Reproductive Medicine / Q000379:methods* / Q000592:standards; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic; D016896:Treatment Outcome