Does the Presence of Blood in the Catheter or the Degree of Difficulty of Embryo Transfer Affect Live Birth?

Torie C. Plowden, Micah J. Hill, Shana M. Miles, Benjamin Hoyt, Belinda Yauger, James Segars, John M. Csokmay, Rebecca J. Chason

Research output: Contribution to journalArticle

Abstract

The technique used for embryo transfer (ET) can affect implantation. Prior research that evaluated the effect of postprocedural blood of the transfer catheter tip have yielded mixed results, and it is unclear whether this is actually a marker of difficulty of the transfer. Our objective was to estimate the effect of blood at the time of ET and the difficulty of ET on live birth rates (LBR). This retrospective cohort study utilized generalized estimating equations (GEEs) with nesting for repeated cycles for all analyses. Univariate modeling was performed and a final multivariate (adjusted) GEE model accounted for all significant confounders. Embryo transfers were subjectively graded (easy, medium, or hard) by a physician at the time of transfer. The presence of blood at ET was associated with more difficult ETs, retained embryos, and presence of mucous in the catheter. In the univariate analysis, ET with blood was not associated with live birth, while the degree of difficulty for ET had a negative impact on LBR. In the final multivariate GEE model, which accounts for repeated cycles from a patient, the only factors associated with an increased LBR were the degree of difficulty of the ET, female age, and blastocyst transfer. After controlling for confounding variables, the presence of blood in the transfer catheter was not associated with the likelihood of pregnancy and thus was not an independent predictor of cycle outcome. This indicates that the difficulty of the transfer itself was a strong negative predictor of pregnancy.

Original languageEnglish (US)
Pages (from-to)726-730
Number of pages5
JournalReproductive Sciences
Volume24
Issue number5
DOIs
StatePublished - May 1 2017

Fingerprint

Embryo Transfer
Live Birth
Catheters
Birth Rate
Pregnancy
Confounding Factors (Epidemiology)
Cohort Studies
Embryonic Structures
Retrospective Studies
Physicians

Keywords

  • ART
  • blood on catheter
  • degree of difficulty
  • difficult transfer
  • embryo transfer

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Does the Presence of Blood in the Catheter or the Degree of Difficulty of Embryo Transfer Affect Live Birth? / Plowden, Torie C.; Hill, Micah J.; Miles, Shana M.; Hoyt, Benjamin; Yauger, Belinda; Segars, James; Csokmay, John M.; Chason, Rebecca J.

In: Reproductive Sciences, Vol. 24, No. 5, 01.05.2017, p. 726-730.

Research output: Contribution to journalArticle

Plowden, TC, Hill, MJ, Miles, SM, Hoyt, B, Yauger, B, Segars, J, Csokmay, JM & Chason, RJ 2017, 'Does the Presence of Blood in the Catheter or the Degree of Difficulty of Embryo Transfer Affect Live Birth?', Reproductive Sciences, vol. 24, no. 5, pp. 726-730. https://doi.org/10.1177/1933719116667607
Plowden, Torie C. ; Hill, Micah J. ; Miles, Shana M. ; Hoyt, Benjamin ; Yauger, Belinda ; Segars, James ; Csokmay, John M. ; Chason, Rebecca J. / Does the Presence of Blood in the Catheter or the Degree of Difficulty of Embryo Transfer Affect Live Birth?. In: Reproductive Sciences. 2017 ; Vol. 24, No. 5. pp. 726-730.
@article{ee4100eb0ae74828ac0b2d211c75c058,
title = "Does the Presence of Blood in the Catheter or the Degree of Difficulty of Embryo Transfer Affect Live Birth?",
abstract = "The technique used for embryo transfer (ET) can affect implantation. Prior research that evaluated the effect of postprocedural blood of the transfer catheter tip have yielded mixed results, and it is unclear whether this is actually a marker of difficulty of the transfer. Our objective was to estimate the effect of blood at the time of ET and the difficulty of ET on live birth rates (LBR). This retrospective cohort study utilized generalized estimating equations (GEEs) with nesting for repeated cycles for all analyses. Univariate modeling was performed and a final multivariate (adjusted) GEE model accounted for all significant confounders. Embryo transfers were subjectively graded (easy, medium, or hard) by a physician at the time of transfer. The presence of blood at ET was associated with more difficult ETs, retained embryos, and presence of mucous in the catheter. In the univariate analysis, ET with blood was not associated with live birth, while the degree of difficulty for ET had a negative impact on LBR. In the final multivariate GEE model, which accounts for repeated cycles from a patient, the only factors associated with an increased LBR were the degree of difficulty of the ET, female age, and blastocyst transfer. After controlling for confounding variables, the presence of blood in the transfer catheter was not associated with the likelihood of pregnancy and thus was not an independent predictor of cycle outcome. This indicates that the difficulty of the transfer itself was a strong negative predictor of pregnancy.",
keywords = "ART, blood on catheter, degree of difficulty, difficult transfer, embryo transfer",
author = "Plowden, {Torie C.} and Hill, {Micah J.} and Miles, {Shana M.} and Benjamin Hoyt and Belinda Yauger and James Segars and Csokmay, {John M.} and Chason, {Rebecca J.}",
year = "2017",
month = "5",
day = "1",
doi = "10.1177/1933719116667607",
language = "English (US)",
volume = "24",
pages = "726--730",
journal = "Reproductive Sciences",
issn = "1933-7191",
publisher = "SAGE Publications Inc.",
number = "5",

}

TY - JOUR

T1 - Does the Presence of Blood in the Catheter or the Degree of Difficulty of Embryo Transfer Affect Live Birth?

AU - Plowden, Torie C.

AU - Hill, Micah J.

AU - Miles, Shana M.

AU - Hoyt, Benjamin

AU - Yauger, Belinda

AU - Segars, James

AU - Csokmay, John M.

AU - Chason, Rebecca J.

PY - 2017/5/1

Y1 - 2017/5/1

N2 - The technique used for embryo transfer (ET) can affect implantation. Prior research that evaluated the effect of postprocedural blood of the transfer catheter tip have yielded mixed results, and it is unclear whether this is actually a marker of difficulty of the transfer. Our objective was to estimate the effect of blood at the time of ET and the difficulty of ET on live birth rates (LBR). This retrospective cohort study utilized generalized estimating equations (GEEs) with nesting for repeated cycles for all analyses. Univariate modeling was performed and a final multivariate (adjusted) GEE model accounted for all significant confounders. Embryo transfers were subjectively graded (easy, medium, or hard) by a physician at the time of transfer. The presence of blood at ET was associated with more difficult ETs, retained embryos, and presence of mucous in the catheter. In the univariate analysis, ET with blood was not associated with live birth, while the degree of difficulty for ET had a negative impact on LBR. In the final multivariate GEE model, which accounts for repeated cycles from a patient, the only factors associated with an increased LBR were the degree of difficulty of the ET, female age, and blastocyst transfer. After controlling for confounding variables, the presence of blood in the transfer catheter was not associated with the likelihood of pregnancy and thus was not an independent predictor of cycle outcome. This indicates that the difficulty of the transfer itself was a strong negative predictor of pregnancy.

AB - The technique used for embryo transfer (ET) can affect implantation. Prior research that evaluated the effect of postprocedural blood of the transfer catheter tip have yielded mixed results, and it is unclear whether this is actually a marker of difficulty of the transfer. Our objective was to estimate the effect of blood at the time of ET and the difficulty of ET on live birth rates (LBR). This retrospective cohort study utilized generalized estimating equations (GEEs) with nesting for repeated cycles for all analyses. Univariate modeling was performed and a final multivariate (adjusted) GEE model accounted for all significant confounders. Embryo transfers were subjectively graded (easy, medium, or hard) by a physician at the time of transfer. The presence of blood at ET was associated with more difficult ETs, retained embryos, and presence of mucous in the catheter. In the univariate analysis, ET with blood was not associated with live birth, while the degree of difficulty for ET had a negative impact on LBR. In the final multivariate GEE model, which accounts for repeated cycles from a patient, the only factors associated with an increased LBR were the degree of difficulty of the ET, female age, and blastocyst transfer. After controlling for confounding variables, the presence of blood in the transfer catheter was not associated with the likelihood of pregnancy and thus was not an independent predictor of cycle outcome. This indicates that the difficulty of the transfer itself was a strong negative predictor of pregnancy.

KW - ART

KW - blood on catheter

KW - degree of difficulty

KW - difficult transfer

KW - embryo transfer

UR - http://www.scopus.com/inward/record.url?scp=85018780696&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85018780696&partnerID=8YFLogxK

U2 - 10.1177/1933719116667607

DO - 10.1177/1933719116667607

M3 - Article

C2 - 27655772

AN - SCOPUS:85018780696

VL - 24

SP - 726

EP - 730

JO - Reproductive Sciences

JF - Reproductive Sciences

SN - 1933-7191

IS - 5

ER -