Advanced 3D/4D ultrasound to guide embryo transfer during in vitro fertilization improves pregnancy rates

Using advanced 3D/4D ultrasound to guide embryo transfer during in vitro fertilization (IVF) significantly reduces a woman's risk of ectopic pregnancy and its associated complications, Robert Gergely, M.D., medical director, 3D Sonography Center of Beverly Hills, reported today.

“They are particularly traumatic for those who turn to IVF in hopes of having a baby. The good news is that 3D/4D ultrasound-guided embryo transfer targeting the Maximal Implantation Potential Point significantly decreases the risk of ectopic pregnancy while it increases the chance of a successful pregnancy.”

Presenting to the 2010 European Society of Human Reproduction and Embryology (ESHRE) Annual Meeting in Rome, Dr. Gergely announced results from a study of 5,073 women receiving IVF and embryo transfer at a large Southern California IVF center. Using 3D/4D ultrasound, Dr. Gergely was able to pinpoint the exact spot within the uterus where infertility specialists could place an embryo with the greatest chance of successful implantation. Dr. Gergely calls this the "Maximal Implantation Potential Point" (MIP Point).




Less sophisticated 2D ultrasound technology lacks the ability to locate the MIP Point. In 2009, Dr. Gergely reported that when the MIP Point was located with 3D/4D ultrasound and the embryo transferred to it, the pregnancy rate at the center rose 10.04%.

Additional analysis has revealed that the ectopic pregnancy rate per embryo transfer declined at the center from 1.82% using 2D ultrasound to 0.50% after adopting 3D/4D ultrasound targeting the MIP Point. This 73.1% decrease is highly statistically significant, and marks the first time such data have been reported.

In ectopic pregnancies, an embryo implants outside the uterus, typically in one of the fallopian tubes. As it grows, it can rupture, causing pain and heavy bleeding that can endanger the mother's life. Normally occurring in about 2% of natural pregnancies, ectopic pregnancy rates have historically been higher in IVF patients, ranging from 2.1% to 8.6%.

"Ectopic pregnancies can be devastating, both physically and emotionally," Dr. Gergely said. "They are particularly traumatic for those who turn to IVF in hopes of having a baby. The good news is that 3D/4D ultrasound-guided embryo transfer targeting the Maximal Implantation Potential Point significantly decreases the risk of ectopic pregnancy while it increases the chance of a successful pregnancy."

Using 2D ultrasound, IVF doctors must rely on guesswork to locate an implantation point. They may transfer several embryos to increase the odds of a successful pregnancy. However, this increases the likelihood of multiple births, which carries a risk of serious complications including premature birth, cerebral palsy and infant death.

Single embryo transfer, advocated by fertility organizations, requires greater precision and accuracy. By targeting the MIP Point, doctors can increase the likelihood that embryo implantation will succeed, reducing the need to transfer multiple embryos and decreasing the risk of complications, Dr. Gergely explained.

"Focusing on the MIP Point frees the physician from trying to guess the optimal point for embryo placement," Dr. Gergely said. "By overcoming the limitations of 2D ultrasound, 3D/4D ultrasound-guided embryo transfer targeting the Maximal Implantation Potential Point increases the pregnancy rate while significantly reducing the risk of ectopic pregnancy and complications associated with multiple births."

Dr. Gergely, who invented and holds the patent on 3D/4D ultrasound-guided embryo transfer, lectures at international conferences and teaches physicians so that the procedure can become available to patients worldwide.

3D/4D Ultrasound-Guided Embryo Transfer Targeting Maximal Implantation Potential (MIP) Point Increases Pregnancy Rate and Reduces Ectopic Pregnancies. Presented June 30, 2010 at the 26th Annual Meeting of the European Society of Human Reproduction and Embryology, Rome, Italy. www.eshre.com

IVF blunder couple left devastated

A couple who underwent fertility treatment have spoken of their devastation at their last embryo being accidentally implanted in another woman. The couple said they had been excited about trying for a second child with their only remaining embryo when the IVF Wales clinic, in Cardiff, admitted the mistake.

The Cardiff and Vale NHS Trust has apologised to the pair, from south Wales, and said changes have been made in a bid to prevent such a mistake happening again.

A heavy staff workload is understood to have been a factor in the human error being made.

The woman, a 38-year-old hospital worker, said nine embryos were created using IVF in 2000 and she gave birth to a son three years later.

The remaining embryos were stored until 2007 when she and her husband, a 40-year-old printing plant manager, decided to try for a second child. One of the embryos had survived and they travelled to the clinic for treatment only to be told the devastating news.

"In less than ten seconds our wonderful world was shattered when the senior embryologist stood in front of us and said, 'I'm very sorry to tell you, but there's been an accident in the lab. Your embryo has been destroyed'," the woman told the Mail on Sunday.

"We were both rooted to our seats. We were stunned and trembling. We held each other tightly, and sobbed and sobbed. It was like water from a tap. I kept thinking, "They've killed our baby! Killed our baby!"

She said it was not until later they discovered the embryo had been implanted in another woman who elected to have a termination when she found out what had happened.

The Trust has admitted liability and the couple have been paid an undisclosed sum of money. Ian Lane, the Trust's Medical Director, said: "We apologise unreservedly for this mistake."