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EMBRYO VE FUNDAL ENDOMETRİAL YÜZEY ARASINDAKİ MESAFENİN İNTRA SİTOPLAZMİK SPERM İNJEKSİYONU SİKLUSLARINDA SONUÇLARA ETKİSİ The Effect of the Distance Between Embryo and Fundal Endometrial Surface on the Success of Intracytoplasmic Sperm Injection Cycles

Amaç: Çalışmadaki amacımız, intrastoplazmik sperm injeksiyonu (İCSİ) sikluslarında embryo transferi sıra-sında ölçülen embryo ile fundal endometrial yüzey arası mesafenin (EFM) implantasyon, klinik gebelik, evebebek götürme ve abort oranlarına etkisini araştırmaktır.Gereç ve Yöntem: Taze non-donor İCSİ siklusuna alınan ve embryo transferi (ET) gerçekleştirilen 176 has-ta retrospektif olarak çalışmaya alındı. 3 damla tekniği ile Wallace katetere yüklenen embryo/embriyolartransabdominal ultrason eşliğinde transfer edildi ve transfer sırasında EFM ölçüldü. Hastalar EFM’e göre≤15 mm, 15-20 mm, ≥20 mm olarak 3 gruba kategorize edildi. ET’den 14 gün sonra bakılan gebelik testininpozitif olması ‘implantasyon’, transvaginal ultrasonda gestasyonel kese görülmesi ‘klinik gebelik’ ve viablcanlı bebek doğumu ‘eve bebek götürme’ olarak kabul edildi.

The Effect of the Distance Between Embryo and Fundal Endometrial Surface on the Success of Intracytoplasmic Sperm Injection Cycles

Purpose: To investigate the effect of the distance between embryo and fundal endometrial surface (EFD) on implantation, clinical pregnancy (CP), take home baby and abortion rates among intracytoplasmic sperm injection (ICSI) cycles. Material and Methods: This was a retrospective clinical trial including 176 primer infertile women undergoing embryo transfer (ET) following fresh non–donor ICSI cycle. Embryo/embryos were transferred by Wallace catheter via three-drop technique under transabdominal ultrasound and EFD was measured. The participants were divided into three groups on the basis of EFD: ≤15 mm, 15-20 mm, and ≥20 mm. ‘Implantation’ was defined as positive pregnancy test following ET, ‘CP’ was described as the presence of a gestational sac in transvaginal ultrasonographic examination and ‘take home baby’ was described as having a living infant. Pregnancy loss before 20 gestational week was accepted as ‘abortion’. Results: Implantation and CP were higher in EFM≥20 mm group, however, take home baby rates were higher in EFD≤15 mm group compared the others. Abortion was more prevelant in EFD≥20mm group. Implantation, CP, take home baby and abortion rates were comparable among three groups. There were no ectopic pregnancies in any groups. Pregnant and non-pregnant groups were significantly different from each other with regard to total oocyte count, metaphase II count, embryo count. In women who conceived, aforementioned parameters were significantly higher compared to women who didn’t conceived. Implantation, CP and take home baby rates were not affected by EFD even variables which were known to affect ICSI success were taken as cofactors with EFD. Discussion: EFD does not affect clinical success of ICSI cycles, however, take home baby rates appeared to be higher in cases with EFD≤15 mm. Further well-designed randomized clinical controlled trials with large sample-sized are needed to optimize EFD.

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