https://orcid.org/0000-0002-1663-5954
Abstract
Objective
To evaluate the effectiveness of transvaginal ultrasound (TVUS) versus the transabdominal ultrasound (TAUS) guided embryo transfer (ET) in obese patients undergoing Intracytoplasmic sperm injection (ICSI).
Design
A prospective randomized controlled trial.
Setting
University hospital.
Patient(s)
Eight hundred participants with BMI ≥30 received the long agonist protocol. They were randomized into 2 equal groups of 400 patients. Each group had either TAUS guided ET or TVUS guided ET.
Main Outcome Measure(s)
Our primary outcomes were clinical pregnancy rate, degree of patient pain assessed by visual analogue scale (VAS). The secondary outcomes were live birth rate, implantation rate, miscarriage and chemical pregnancy rates, duration of ET.
Result(s)
Our results showed a significant higher chemical and clinical pregnancy rates in the TVUS group in comparison to TAUS group (45.3% vs. 38.3%, p=0.045) and (37.8% vs. 30.8%, p=0.044) respectively. There was tendency for increased live birth rates in the TVUS group however it did not reach statistical significance (50.2% vs. 44.8%). The VAS of the pain was significantly less in TVUS group in comparison to the TAUS group (2.1 ±0.7 vs. 4.5 ±1.3), also abdominal discomfort was significantly less in TVUS group in comparison to the TAUS group (13% vs. 58%) p= value 0.0001.
Conclusion(s)
This study showed superior role of TVUS guided ET over TAUS regarding less pain and better pregnancy and live birth rates in obese participants.
Clinical Trial Registration Number
Clinical trial. Gov identifier NCT03473028.
Keywords:
Data Sharing Statement
Availability of data and material: the authors intend to share individual deidentified participant data, regarding the demographic data and the results, if required anytime, you can contact Yomna Ali Bayoumi,1 M.D.
Ethics
The study was conducted in accordance with the Declaration of Helsinki and Ethics approval from obstetrics and gynecology scientific committee.
Consent to Participate
All patients enrolled in the study consented to participate.
Synopsis
A Randomized controlled trial showed superior role of TVUS-guided ET over TAUS as regards better pregnancy and live birth rates in obese patients undergoing ICSI.
Acknowledgments
The authors thank all of the female participants and the staff of the Cairo University IVF Center for their help and support.
Disclosure
All authors declare no conflict of interest.