title: Embryo transfer simulation improves pregnancy rates and decreases time to proficiency in Reproductive Endocrinology and Infertility fellow embryo transfers.
abstract: To design and evaluate an ET simulator to train Reproductive Endocrinology and Infertility (REI) fellows' techniques of ET.
  
  
  
  Simulation model development and retrospective cohort analysis.
  
  
  
  Not applicable.
  
  
  
  Patients undergoing IVF.
  
  
  
  Simulation model evaluation and implementation of ET simulation training.
  
  
  
  Pregnancy rates.
  
  
  
  The REI fellow and faculty evaluation responses (n = 19/21 [90%]) of the model demonstrated realistic characteristics, with evaluators concluding the model was suitable for training in almost all evaluated areas. A total of 12 REI fellows who performed ET were analyzed: 6 before ET trainer and 6 after ET trainer. Pregnancy rates were 31% in the initial 10 ETs per fellow before simulator vs. 46% after simulator. One of six pre-ET trainer fellows (17%) had pregnancy rates ≥40% in their first 10 ETs; whereas four of six post-ET trainer fellows had pregnancy rates ≥40% in their first 10 ETs. The average number of ETs to obtain >40% pregnancy efficiency was 27 ETs before trainer vs. 15 ETs after trainer. Pregnancy rates were similar in the two groups after 20 ETs, and collective terminal pregnancy rates were >50% after 40 ETs.
  
  
  
  Embryo transfer simulation improved REI fellow pregnancy rates in their first 10 transfers and led to a more rapid ET proficiency. These data suggest potential value in adopting ET simulation, even in programs with a robust history of live ET in fellowship training.
authors.affiliation: Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, Bethesda, Maryland; Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Madigan Army Medical Center, Tacoma, Washington. Electronic address: Ryan.J.Heitmann.mil@mail.mil.
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Heitmann
authors.affiliation: Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, Bethesda, Maryland.
authors.forename: Micah J
authors.initials: MJ
authors.lastname: Hill
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, Bethesda, Maryland.
authors.forename: John M
authors.initials: JM
authors.lastname: Csokmay
authors.affiliation: Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, Bethesda, Maryland.
authors.forename: Justin
authors.initials: J
authors.lastname: Pilgrim
authors.affiliation: Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
authors.forename: Alan H
authors.initials: AH
authors.lastname: DeCherney
authors.affiliation: Department of Obstetrics and Gynecology, Uniformed University of the Health Sciences, Bethesda, Maryland.
authors.forename: Shad
authors.initials: S
authors.lastname: Deering
mesh_terms: D000293:Adolescent; D000328:Adult; D002983:Clinical Competence / Q000706:statistics & numerical data*; D004521:Educational Measurement / Q000706:statistics & numerical data; D004624:Embryo Transfer / Q000379:methods / Q000706:statistics & numerical data*; D004704:Endocrinology / Q000193:education; D005260:Female; D000070856:High Fidelity Simulation Training / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology / Q000628:therapy*; D011247:Pregnancy; D018873:Pregnancy Rate; D018456:Reproductive Medicine / Q000193:education*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Embryo transfer; fellowship education; medical simulation training; model development; pregnancy rates