What data should be noted during an embryo transfer for use in prospective and retrospective studies, including patient and embryo characteristics, transfer procedure, and medications used, such as In Vitro Fertilization (IVF) protocols and ovarian stimulation treatments?

Essential Data to Record During Embryo Transfer for Research Studies

For comprehensive research in IVF, detailed documentation of embryo transfer procedures is critical to enable meaningful retrospective and prospective analyses that can improve outcomes and reduce complications. 1

Patient Characteristics

• Record complete demographic information including age, BMI, ethnicity, and socioeconomic factors 1
• Document detailed infertility history including duration, primary vs. secondary infertility, and previous treatment outcomes 1
• Note medical comorbidities that may impact outcomes, especially those with obstetrical or medical contraindications to multiple pregnancies 2
• Record ovarian reserve markers (AMH, FSH, antral follicle count) as these correlate with response and outcomes 3
• Document previous pregnancy outcomes, particularly any history of recurrent pregnancy loss 3

Stimulation Protocol Details

• Record complete stimulation protocol information including medication types, dosages, and duration 1
• Document ovarian response parameters including number of follicles, estradiol levels, and any complications such as OHSS 4
• Note trigger type and timing in relation to oocyte retrieval 1
• Record number of oocytes retrieved, maturity rates, and fertilization method (conventional IVF vs. ICSI) 1, 5

Embryo Characteristics

• Document detailed embryo quality assessments using standardized grading systems 5
• Record embryo development parameters including fertilization rates, cleavage rates, and blastulation rates 5, 6
• Note any genetic testing performed (PGT-A, PGT-M, or non-invasive testing) and results 5
• Document embryo selection methods used (morphology, time-lapse, AI algorithms) 5
• Record embryo stage at transfer (cleavage vs. blastocyst) 2, 6

Transfer Procedure Details

• Document number of embryos transferred, which is critical for analyzing outcomes and multiple pregnancy rates 1
• Record whether transfer was elective single embryo transfer (eSET) or multiple embryo transfer 1
• Note transfer difficulty level (easy, moderate, difficult) and any complications 6, 7
• Document catheter type used for transfer as this may impact outcomes 6
• Record use of ultrasound guidance during transfer 6
• Document embryo loading technique and transfer medium used 8, 6
• Note the exact location of embryo deposition within the uterine cavity 6
• Record presence of blood or mucus on catheter after transfer 6
• Document retention of embryos in catheter requiring repeat transfer 6

Post-Transfer Management

• Record luteal phase support protocol (medication types, dosages, duration) 7
• Document any adjunctive treatments used (aspirin, heparin, antibiotics) 6
• Note post-transfer instructions given to patients (bed rest duration, activity restrictions) 6
• Record any complications following transfer 7

Outcome Measures

• Document biochemical pregnancy rates (positive hCG) 1
• Record clinical pregnancy rates (presence of gestational sac) 1
• Note ongoing pregnancy rates at various gestational ages 1
• Document live birth rates as the ultimate outcome measure 1
• Record multiple pregnancy rates and complications 1
• Document pregnancy complications and perinatal outcomes 1

Statistical Considerations

• Ensure proper denominator selection for outcome reporting (per started cycle, per oocyte retrieval, per embryo transfer) 1
• Record cumulative outcomes across multiple transfers from a single stimulation cycle 1
• Document patient-specific, embryo-specific, and cycle-specific determinants of implantation 2

Common Pitfalls to Avoid

• Avoid using inconsistent embryo grading systems that prevent comparison between studies 1, 5
• Do not report outcomes only for subgroups of patients who reached certain treatment stages, as this disrupts the randomization balance 1
• Avoid reporting live birth per embryo transferred, as embryos are not statistically independent 1
• Do not use multiple outcome measures without specifying primary outcomes, as this increases risk of false discoveries 1
• Avoid inconsistent definitions of live birth (include gestational age cutoffs as recommended by IMPRINT) 1