title: Comparison of easy and difficult embryo transfer outcomes in in vitro fertilization cycles.
abstract: BACKGROUND
  The aim of this study was to compare the effects of easy and difficult embryo transfers (ET) on implantation and pregnancy rates.
  
  
  METHODS
  In this prospective study, we analyzed the results of 706 ET procedures over a 12-month period. An easy ET was defined as a transfer that occurred without the use of force or other instrumentation. A difficult ET was defined as the use of force for catheter placement, and/or the use of additional instruments, and/or manipulation. Pregnancy rate was compared between patients with easy or difficult ETs.
  
  
  RESULTS
  There was a significantly higher implantation rate in the easy group (21.7%) compared to the difficult group (12.1%, p<0.05).The easy group had a higher pregnancy rate (38.1%) compared to patients who had difficult ETs (21.4%; p<0.05).
  
  
  CONCLUSIONS
  Any uterine manipulation during ET adversely affects in vitro fertilization (IVF). Precaution should be taken to identify possibly difficult ET cases in advance.
authors: Department of Endocrinology and Female Infertility at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
authors: Firouzeh
authors: F
authors: Ghaffari
authors: Department of Endocrinology and Female Infertility at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
authors: Kiandokht
authors: K
authors: Kiani
authors: Department of Endocrinology and Female Infertility at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
authors: Akram
authors: A
authors: Bahmanabadi
authors: Department of Statistics, Mathematical Science and Computer Faculty, Shahid Chamran University, Ahwaz, Iran ; Department of Epidemiology and Reproductive Health at Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
authors: Mohammadreza
authors: M
authors: Akhoond
keywords: Embryo Transfer; Implantation; Pregnancy Outcomes