Effect of embryo transfer depth on IVF/ICSI outcomes: A randomized clinical trial.

Robab Davar, Poormoosavi SM, Mohseni F, Janati S
International journal of reproductive biomedicine · 2020 · doi:10.18502/ijrm.v13i9.7667 · PMID:33062918 · PMC7521168
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-08-07 ⓘ

Transferring embryos 25 ± 5 mm from the fundal endometrial surface, versus 15 ± 5 mm, significantly improved implantation, chemical, and clinical pregnancy rates in IVF/ICSI cycles.

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This randomized clinical trial investigated the impact of embryo transfer depth on IVF/ICSI outcomes by comparing deposition at 15 ± 5 mm versus 25 ± 5 mm from the fundal endometrial surface in 180 women. The study excluded patients with specific uterine pathologies, including grade III and IV endometriosis, to isolate the effect of transfer location. Results demonstrated that transferring embryos deeper at 25 mm significantly improved implantation, chemical pregnancy, and clinical pregnancy rates compared to the shallower 15 mm position, although ongoing pregnancy rates did not differ significantly. Relevance to endometriosis: The paper explicitly excludes women with endometriosis as a criterion for participation, thereby limiting its direct applicability to this patient population while focusing on general ART mechanics.

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Abstract

BackgroundAlthough there has been remarkable advancement in the field of assisted reproductive technology, implantation failure remains a significant issue in most infertile couples receiving these treatments. Embryo transfer is important in assisted reproductive technology and directly affects the implantation rates and pregnancy outcomes.ObjectiveTo assess the effect of two different distance embryo transfer sites from fundal endometrial surface on the outcomes of in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles.Materials and methodsA total of 180 women who were candidate for IVF/ ICSI/ embryo transfer in Yazd Research and Clinical Center for Infertility were equally assigned to two groups based on the distance between the fundal endometrial surface and catheter tip to investigate implantation, chemical and clinical pregnancy (group A: 15 ± 5 mm and group B: 25 ± 5 mm, respectively).ResultsThe subjects in the group B showed significantly higher implantation rate, chemical and clinical pregnancy rate compared to the group A (p = 0.03, 0.01, 0.04, respectively). The rate of ongoing pregnancy and miscarriage indicated no significant differences between groups (p = 0.21, 0.27, respectively).ConclusionIn conclusion, our study showed that the depth of embryo replacement inside the uterine cavity at a distance of 25 ± 5 mm beneath fundal endometrial surface have better effects on the pregnancy outcomes of IVF/ICSI cycles and can be considered as an important factor to improve the success of IVF cycles.
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According to the results, the rates of implantation, chemical and clinical may be influenced by the site of embryo transfer. Moreover, favorable outcomes were achieved with the catheter tip at the distance of 25 ± 5 mm beneath the fundal endometrial surface and it can be considered as an important factor to improve the success of IVF cycles.

Coi Statement

The authors declare that there is no conflict of interest.

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