Is There Any Effect of the Physician Performing Embryo Transfer in IVF-ICSI Treatment: A Prospective Cohort Study

Abstract

Objective To evaluate whether there is an effect of the physician who transfers the embryos on pregnancy rates in in vitro fertilization-intracytoplasmic sperm injection (IVF-ICSI) treatment.

Methods A total of 757 participants were analyzed between 2012 and 2017. Participants were classified according to 3 physicians who transferred the embryos: ([group 1 = 164 patients]; [group 2 = 233 patients]; [group 3 = 360 patients]). Baseline parameters and IVF-ICSI outcomes were compared between the groups.

Results No differences were determined between the groups regarding the baseline parameters (age, age subgroups [20–29, 30–39, and ≥ 40 years old)], body mass index (BMI), smoking status, infertility period, cause of infertility, baseline follicle stimulating hormone, luteinizing hormone, estradiol (E₂), thyroid stimulating hormone, prolactin levels, antral follicle count, duration of stimulation, stimulation protocol, gonadotropin dose required, maximum E₂ levels, progesterone levels, endometrial thickness on human chorionic gonadotropin (hCG) administration and transfer days (p > 0.05). The numbers of oocytes retrieved, metaphase II (MII), 2 pronucleus (2PN), , transferred embryo, fertilization rate, day of embryo transfer, the catheter effect and embryo transfer technique, and clinical pregnancy rates (CPRs) were also comparable between the groups (p > 0.05).

Conclusion Our data suggests that the physician who transfers the embryos has no impact on CPRs in patients who have undergone IVF-ICSI, but further studies with more participants are required to elucidate this situation.

Resumo

Objetivo Avaliar se há ou não efeito do médico que realiza a transferência de embriões nas taxas de gravidez no tratamento com fertilização in vitro-injeção intracitoplasmática de espermatozoide (FIV-ICSI, na sigla em inglês).

Métodos Um total de 757 participantes foram analisados entre 2012 e 2017. Os participantes foram classificados de acordo com 3 médicos que transferiram os embriões: ([grupo 1 = 164 pacientes]; [grupo 2 = 233 pacientes]; [grupo 3 = 360 pacientes]). Parâmetros basais e resultados de FIV-ICSI foram comparados entre os grupos.

Resultados Nenhuma diferença foi determinada entre os grupos nos parâmetros basais (idade, subgrupos de idade [20-29, 30-39 e ≥ 40 anos)], índice de massa corporal (IMC), tabagismo, período de infertilidade, causa da infertilidade, hormônio folículo estimulante basal , hormônio luteinizante, estradiol (E2), hormônio estimulador da tireoide, níveis de prolactina, contagem de folículos antrais, duração da estimulação, protocolo de estimulação, dose de gonadotrofina necessária, níveis máximos de E2, níveis de progesterona e espessura endometrial na administração de hCG e nos dias de transferência (p > 0,05). O número de oócitos recuperados, MII e 2PN, embrião transferido, taxa de fertilização, dia da transferência do embrião, o efeito do cateter e a técnica de transferência de embrião e taxas clínicas de gravidez (RCPs) também foram comparáveis entre os grupos (p > 0,05).

Conclusão Nossos dados sugerem que o médico que transfere os embriões não tem impacto sobre as RCPs em pacientes que se submeteram a FIV-ICSI, mas mais estudos com mais participantes são necessários para elucidar esta situação.

Keywords

assisted reproductive technology - embryo transfer - infertility physicians - pregnancy rate

Palavras-chave

tecnologia reprodutiva assistida - transferência de embrião - médicos de infertilidade - taxa de gravidez

Contributors

All authors participated in the concept and design of the study, as well as in the analysis and interpretation of data; draft or revision of the manuscript; and they have approved the manuscript as submitted. All authors are responsible for the reported research.

Publikationsverlauf

Eingereicht: 07. Oktober 2020

Angenommen: 06. Oktober 2021

Artikel online veröffentlicht:
29. Januar 2022

• References

• 1 Oruç AS, Yılmaz N, Görkem U, Inal HA, Seçkin B, Gülerman C. Influence of ultrasound-guided artificial insemination on pregnancy rates: a randomized study. Arch Gynecol Obstet 2014; 289 (01) 207-212
• 2 Inal ZO, Gorkemli H, Inal HA. The effect of local injury to the endometrium for implantation and pregnancy rates in ICSI–ET cycles with recurrent implantation failure: a randomised controlled study. Eur J Gen Med 2012; 9 (04) 223-229
• 3 Yilmaz N, Kahyaoglu İ, İnal HA, Görkem Ü, Devran A, Mollamahmutoglu L. Negative life events have detrimental effects on in-vitro fertlization outcome. Hum Fertil (Camb) 2015; 18 (03) 220-224
• 4 Inal HA, Yilmaz N, Gorkem U, Oruc AS, Timur H. The impact of follicular fluid adiponectin and ghrelin levels based on BMI on IVF outcomes in PCOS. J Endocrinol Invest 2016; 39 (04) 431-437
• 5 van Weering HG, Schats R, McDonnell J, Hompes PG. Ongoing pregnancy rates in in vitro fertilization are not dependent on the physician performing the embryo transfer. Fertil Steril 2005; 83 (02) 316-320
• 6 Yao Z, Vansteelandt S, Van der Elst J, Coetsier T, Dhont M, De Sutter P. The efficacy of the embryo transfer catheter in IVF and ICSI is operator-dependent: a randomized clinical trial. Hum Reprod 2009; 24 (04) 880-887
• 7 Yılmaz N, Oruç AS, Zeyrek T, Görkem U, Inal HA, Engin-Üstün Y. et al. Effect of the afterloaded external guidance embryo transfer technique on pregnancy rates in single embryo transfer cycles. J Turk Ger Gynecol Assoc 2013; 14 (03) 153-156
• 8 Ozturk Inal Z, Yilmaz N, Inal HA, Hancerliogullari N, Coskun B. Are there any differences between antagonist administration on days <6 and ≥6 of Controlled Ovarian Hyperstimulation on assisted reproductive technique outcomes?. J Chin Med Assoc 2018; 81 (01) 53-57
• 9 Inal ZO, Inal HA, Aksoy E, Kucukkendirci H. Spermiogram test results of patients presenting to our IVF Center due to infertility. J Clin Anal Med. 2017; 8 (05) 365-369
• 10 Inal ZO, Inal HA, Erdem S. The effect of serum and follicular fluid secreted frizzle-related protein-5 on in vitro fertilization outcomes in patients with polycystic ovary syndrome. Mol Biol Rep 2018; 45 (06) 2037-2044
• 11 Barber D, Egan D, Ross C, Evans B, Barlow D. Nurses performing embryo transfer: successful outcome of in-vitro fertilization. Hum Reprod 1996; 11 (01) 105-108
• 12 Karande VC, Morris R, Chapman C, Rinehart J, Gleicher N. Impact of the “physician factor” on pregnancy rates in a large assisted reproductive technology program: do too many cooks spoil the broth?. Fertil Steril 1999; 71 (06) 1001-1009
• 13 Papageorgiou TC, Hearns-Stokes RM, Leondires MP, Miller BT, Chakraborty P, Cruess D. et al. Training of providers in embryo transfer: what is the minimum number of transfers required for proficiency?. Hum Reprod 2001; 16 (07) 1415-1419
• 14 Visser DS, Fourie FL, Kruger HF. Multiple attempts at embryo transfer: effect on pregnancy outcome in an in vitro fertilization and embryo transfer program. J Assist Reprod Genet 1993; 10 (01) 37-43
• 15 Wisanto A, Janssens R, Deschacht J, Camus M, Devroey P, Van Steirteghem AC. Performance of different embryo transfer catheters in a human in vitro fertilization program. Fertil Steril 1989; 52 (01) 79-84
• 16 Angelini A, Brusco GF, Barnocchi N, El-Danasouri I, Pacchiarotti A, Selman HA. Impact of physician performing embryo transfer on pregnancy rates in an assisted reproductive program. J Assist Reprod Genet 2006; 23 (7-8): 329-332
• 17 Hearns-Stokes RM, Miller BT, Scott L, Creuss D, Chakraborty PK, Segars JH. Pregnancy rates after embryo transfer depend on the provider at embryo transfer. Fertil Steril 2000; 74 (01) 80-86
• 18 Bjuresten K, Hreinsson JG, Fridström M, Rosenlund B, Ek I, Hovatta O. Embryo transfer by midwife or gynecologist: a prospective randomized study. Acta Obstet Gynecol Scand 2003; 82 (05) 462-466
• 19 van de Pas MM, Weima S, Looman CW, Broekmans FJ. The use of fixed distance embryo transfer after IVF/ICSI equalizes the success rates among physicians. Hum Reprod 2003; 18 (04) 774-780