Embryo transfer by midwife or gynecologist: a prospective randomized study.
BACKGROUND
Embryo transfer (ET) in assisted reproduction treatments has traditionally been performed by gynecologists in the Nordic countries. As gynecologists often have a busy schedule, midwives and nurses have become increasingly important in performing the treatment, providing subject information, ultrasound monitoring and assistance at ET. As part of the continuous development of our IVF treatment we have carried out a prospective randomized pilot study where either a midwife or a gynecologist has performed ET. The aim of this study was to see if a skilled IVF midwife could perform ET with similar results to a gynecologist.


METHODS
On the day of oocyte aspiration the subjects were randomized, by means of closed envelopes, for ET to be performed either by a midwife or a gynecologist. A total of 102 subjects were included in the study, 51 for ET by a skilled midwife and 51 by a gynecologist. There were no differences in the groups in respect to ET routine and catheters used.


RESULTS
No significant differences were observed in subject characteristics as regards age, method of pituitary down-regulation or proportion of IVF/ICSI cycles. Similar clinical pregnancy rates between ETs performed by midwives vs. gynecologists, 31% vs. 29%, respectively, were seen. Subject experience as judged by a questionnaire also showed high acceptance of ET by a midwife.


CONCLUSIONS
The results show that it is a feasible option to allow midwives to carry out ETs.
Bjuresten
Kerstin
K
Department of Obstetrics and Gynaecology, Karolinska Institute, Huddinge University Hospital, Stockholm, Sweden. Kerstin.Bjuresten@hs.se
Hreinsson
Julius G
JG
Fridström
Margareta
M
Rosenlund
Björn
B
Ek
Ingvar
I
Hovatta
Outi
O
D000328:Adult; D002983:Clinical Competence; D004624:Embryo Transfer / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods* / Q000706:statistics & numerical data; D006176:Gynecology / Q000379:methods; D006801:Humans; D008297:Male; D008880:Midwifery / Q000379:methods*; D017060:Patient Satisfaction; D010820:Physicians / Q000592:standards*; D010865:Pilot Projects; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013548:Sweden; D013997:Time Factors