title: Impact of technical difficulties, choice of catheter, and the presence of blood on the success of embryo transfer--experience from a single provider.
abstract: OBJECTIVE
  To investigate the impact of technical difficulties, choice of catheter, and the presence of blood during embryo transfer on the results of in vitro fertilization and ICSI.
  
  
  METHODS
  A cohort of 784 consecutive cycles in 655 in vitro fertilization and ICSI patients were studied.
  
  
  RESULTS
  Negotiating the cervix, using the volsellum, presence of blood on the catheter wall or on the cervix did not affect the results. Changing the catheter and blood on the catheter tip reduced the pregnancy (P < 0.05 and P < 0.05) and implantation rates (P < 0.001 and P < 0.01). The Ultrasoft catheter produced higher pregnancy (P < 0.0005) and implantation rates (P < 0.01) compared to the more rigid Frydman catheter.
  
  
  CONCLUSIONS
  Negotiation of the cervix, the use of a volsellum, and the presence of blood on the catheter wall or on the cervix do not affect the results. Changing the catheter and blood on the catheter tip significantly diminish the pregnancy and implantation rates. Soft catheters perform better.
authors.affiliation: Department of Obstetrics and Gynaecology, The University of Alexandria, Alexandria, Egypt 21615. hnsallam@link.net
authors.forename: Hassan N
authors.initials: HN
authors.lastname: Sallam
authors.forename: Abdel Fattah
authors.initials: AF
authors.lastname: Agameya
authors.forename: Ashraf Farrag
authors.initials: AF
authors.lastname: Rahman
authors.forename: Fathy
authors.initials: F
authors.lastname: Ezzeldin
authors.forename: Ahmed N
authors.initials: AN
authors.lastname: Sallam
mesh_terms: D016063:Blood Loss, Surgical / Q000503:physiopathology / Q000706:statistics & numerical data*; D002404:Catheterization / Q000295:instrumentation*; D002584:Cervix Uteri / Q000378:metabolism*; D004624:Embryo Transfer; D005260:Female; D006801:Humans; D011247:Pregnancy