title: Assisted reproduction outcomes after embryo transfers requiring a malleable stylet.
abstract: OBJECTIVE
  This retrospective case-control study was undertaken to assess the impact of a malleable stylet application on embryo transfer (ET) outcome.
  
  
  METHODS
  The Wallace malleable stylet was used when the soft inner catheter could not negotiate the internal os during ultrasound-guided ET. Patients having an age ≤37 years, with three embryos replaced were included in the analysis. Implantation rate, clinical pregnancy rate and live birth rate were the main outcome measures.
  
  
  RESULTS
  The Wallace malleable stylet was applied in 164 (29.6%) of the 553 ETs evaluated. Implantation rate, clinical pregnancy rate and live birth rate showed a 5.6% (19.4% vs. 13.8%), a 10.8% (41.9% vs. 31.1%) and a 9.9% (37.3% vs. 27.4%) absolute difference, respectively, in favor of ETs not requiring the stylet. These differences were statistically significant (P < 0.05).
  
  
  CONCLUSIONS
  ETs requiring stylet are associated with lower implantation, clinical pregnancy and live birth rates.
authors.affiliation: Unità di Procreazione Medicalmente Assistita, Dipartimento di Medicina e Scienze dell'Invecchiamento, Facoltà di Medicina e Chirurgia, Università, G. d'Annunzio, Chieti-Pescara, Ospedale, Bernabeo, Ortona, Chieti, Italy. tiboni@unich.it
authors.forename: Gian Mario
authors.initials: GM
authors.lastname: Tiboni
authors.forename: Enrica Concetta
authors.initials: EC
authors.lastname: Colangelo
authors.forename: Emiliana
authors.initials: E
authors.lastname: Leonzio
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Gabriele
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002584:Cervix Uteri; D010064:Embryo Implantation; D004624:Embryo Transfer / Q000295:instrumentation*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008297:Male; D010062:Ovulation Induction; D011247:Pregnancy; D011256:Pregnancy Outcome; D027724:Reproductive Techniques, Assisted / Q000295:instrumentation*; D012189:Retrospective Studies