Lab Practical: Embryo Transfer Flashcards
At what point to most IVF cycles ‘fail’
after embryo transfer there is no pregnancy
What three things are embryos graded on
Blastocyst development and stage status
Inner cell mass quality
Trophectoderm quality
Breakdown the embryo grading system more specifically
Stage:
1 cavity less than half the volume
2 cavity more than half the volume
3 full blastocyst, cavity completely fills
4 expanded, cavity larger than embryo, thinning of shell
5 hatching
ICM:
A many cells, tightly packed
B several cells, loosely grouped
C very few cells
Trophecto derm
A many cells , cohesive layer
B few cells, forming a loose epithelium
C very few large cells
What is the grading given to a top quality egg
5aa
What are the policis on single embryo transfer according to maternal age
under 35 years: one top grade embryos, regardless of the number attempted
35-38 years: at lease one top grade embryo, are on their first or second full cycle
more than 38 yrs L at least one top grade embryo - are on their first full cycle
more than 40 yrs :
may consider double embryo transfer
What has been shown to improve success of embryo transfer
full bladder
How can the tip of the probe be seen on ultrasound
it has an echogenic tip
What are the risks of embryo transfer
trauma to uterus embryo is not transferred pregnancy does not occur trauma to cervix ectopic pregnancy multiple pregnancy
what can happen when the uterous is traumatised during trasfer
can cause uterine contractions which reduce IR/PR
what are the disadvantaged of an ultrasound guided embryo transfer
need second/trained operator increased procedural tume
inconvienience of full bladder
catherer movement to impore identification can disrupt endometrium
effects of early US on preimplantation emrb
what is the evidence to show that ultrasound guided ET is preferable to clinical touch
Increased in continuing pregnancy rate
increase in live birth rate
decrease in difficult transfer rate
no difference in
miscarriage
ectopic rate
blood on catheter rate (associated with decrease IR/PR)
where in the uterin cavity should the embryo be transferred for best success
20mm away from fundus
DOES removing cervical mucus improve pregnancy/implantation orlive brith rate
no evidence of improvement
When would a mock transfer be done
vaginismus/psychosexual problems
previous LSCS
cervical surgery
however no evidence of benefit
what is the ideal ET catheter
should be soft to avoid trauma but malleable enough to pass through cervix into uterus
