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Mock embryo transfer Is it right to mock?

Amit Shah, Anil Gudi & Prof Homburg

In-vitro fertilisation (IVF) treatment involves a series of procedures starting with hormonal stimulation of the ovary and ending with hormonal support of the part of the treatment cycle following the placement of embryos in the uterus. In between these two, eggs must be extracted from the ovaries, fertilised and nurtured for a few days by the embryologists before being placed in the uterus. The transfer of the embryo into the cavity of the uterus would appear to be one of the simplest technical procedures in this chain of events. However, recent research has revealed that it is a step that has a critical effect on the success of the treatment. For example, experienced IVF practitioners consistently achieved better results than their more junior counterparts. Using ultrasound to guide the placement of the fertilised egg in the right place in the uterine cavity is being argued as a help in improving results.

The problem is, of course, that no two wombs are the same. Some bend forwards, some backwards, in some the neck of the womb is tight closed, in others gaping open. The length of the cavity is another important variable and some may be partly obstructed by an unexpected fibroid or polyp. On the strength of two clichés, practice makes perfect and forewarned is forearmed, many units now perform a ‘mock transfer’ at some time before the real one. Important knowledge is gained in a painless procedure and recorded so that when the day of the actual embryo transfer arrives, the practitioner knows exactly what to expect. This can make all the difference between an “easy” transfer and a “difficult” transfer with a consequent difference in the results of the treatment.

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