title: Transvaginal versus transabdominal ultrasound guidance for embryo transfer in donor oocyte recipients: a randomized clinical trial.
abstract: OBJECTIVE
  To compare pregnancy and implantation rates with transvaginal (TV) versus transabdominal (TA) ultrasound-guided embryo transfer (ET).
  
  
  METHODS
  Randomized, clinical trial registered at clinicaltrials.gov (NCT 01137461).
  
  
  METHODS
  Private, infertility clinic.
  
  
  METHODS
  Three-hundred thirty randomized recipients of donor oocytes.
  
  
  METHODS
  Embryo transfer using TV (with empty bladder, using the Kitazato ET Long catheter) versus TA ultrasound guidance (with full bladder, using the echogenic Sure View Wallace catheter).
  
  
  METHODS
  Overall pregnancy, clinical pregnancy, implantation, and ongoing pregnancy rates. Duration and difficulty of ET. Patient-reported uterine cramping and discomfort, as evaluated by questionnaire.
  
  
  RESULTS
  No statistically significant differences were observed in clinical pregnancy 50.9% versus 49.4% (95% confidence interval of the difference: -9.2 to +12.2%), implantation 34.5% versus 31.4% (95% CI of the difference: -4 to +10.3%) between the TV and TA ultrasound-guided groups. Transfer difficulty (6% versus 4.2%) and uterine cramping (27.2% versus 18.3%) were not statistically significantly different between treatment groups. Total duration (154±119 versus 85±76 seconds) was statistically significantly higher in the TV ultrasound group. Light to moderate-severe discomfort related to bladder distension was reported by 63% of the patients in the TA ultrasound group.
  
  
  CONCLUSIONS
  Transvaginal ultrasound-guided ET yielded similar success rates compared with the TA ultrasound-guided procedure without requiring the assistance of a sonographer. It was associated with increased patient comfort due to the absence of bladder distension.
authors: Clínica EUGIN, Barcelona, Spain. bodridaniel@gmail.com
authors: Daniel
authors: D
authors: Bodri
authors: Marta
authors: M
authors: Colodrón
authors: Désirée
authors: D
authors: García
authors: Albert
authors: A
authors: Obradors
authors: Valérie
authors: V
authors: Vernaeve
authors: Oriol
authors: O
authors: Coll
mesh_terms: D000328:Adult; D010064:Embryo Implantation; D004624:Embryo Transfer / Q000009:adverse effects; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007246:Infertility / Q000000981:diagnostic imaging / Q000628:therapy*; D018587:Oocyte Donation; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D013030:Spain; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000009:adverse effects / Q000379:methods*; D055815:Young Adult