A meta-analysis of ultrasound-guided versus clinical touch embryo transfer.

OBJECTIVE To determine the relative efficacy of ultrasound-guided embryo transfer and embryo transfer by clinical touch alone. DESIGN Systematic review and meta-analysis of randomized, controlled trials comparing ultrasound-guided embryo transfer with embryo transfer by clinical touch alone. SETTING Infertility centers providing treatment with in vitro fertilization/embryo transfer. PATIENT(S) Women undergoing embryo transfer. INTERVENTION(S) Embryo transfer with or without transabdominal ultrasound guidance. MAIN OUTCOME MEASURE(S) Clinical pregnancy rate and embryo implantation rate. RESULT(S) A total of eight prospective controlled trials were identified. Of these studies, four were nonrandomized or quasi-randomized and four were genuinely randomized. Meta-analysis demonstrated a significantly increased chance of clinical pregnancy following ultrasound-guided embryo transfer in all studies and in the genuinely randomized subgroup. The embryo implantation rate was also significantly increased following ultrasound-guided embryo transfer. CONCLUSION(S) Ultrasound-guided embryo transfer significantly increases the chance of clinical pregnancy and significantly increases the embryo implantation rate.