International Journal of Advances In Case Reports

A CASE REPORT: THE FIRST TRANSVAGINAL ULTRASOUND-GUIDE EMBRYO TRANSFER AND PREGNANCY IN VITRO FERTILIZATION CYCLE IN CANADA.

Michael H. Dahan*, Zhang Lei, Karen Buzaglo, Hai-Ying Chen, Seang Lin Tan

E: dahanhaim@hotmail.com

IVF, Embryo transfer, Transabdominal ultrasound, Transvaginal ultrasound.

Embryo transfer (ET) has been viewed as an important variable in the success of an ART treatment cycle. Transvaginal ultrasound (TVS)-guided ET does not require a full bladder, gives greater resolution of the uterocervical angle, and can more clearly delineate the catheter tip than TAS-guided ET. Nonetheless, it is thought to be technically more difficult because of the necessity to simultaneously place the ultrasound probe, the speculum, and the catheter during the ET. We described the first TVS-guide embryo transfer and pregnancy in Canada. Case: A 34-year-old woman with an 11-year history of primary male factor infertility. The patient consented to a planned Antagonist IVF cycle. A total of 23 oocytes were retrieved, 16 oocytes were at MII stage and the remaining 7 oocytes were at germinal vesicle (GV)stage. 2 blastocyst was transferred on day 5. The TV ultrasound-guided ET was performed with a slight modification (removal of the speculum) to the protocol used routinely at the Montreal Reproduction Clinic (Quebec, Canada). Pregnancy was confirmed by a serum HCG concentration of 569.3IU/L, 11days after embryo replacement. Five weeks after embryo transfer, one gestational sac with positive heart activity was detected. The patient had a live birth. Transvaginal ultrasonography is superior to transabdominal ultrasonography for visualization of the uterus, allows the physician conducting the ET to operate the ultrasound himself, and evidently avoided using the TV approach requiring a fully emptied urinary bladder. Further studies are needed to define the patient groups in whom the TV approach might be superior to the currently more widely used TA ultrasound guidance.