Results: Egg Collection and Embryo Transfer Techniques
Largest survey ever performed in IVF practice!
Results of 261,300 IVF Treatment Cycles 359 centres from 71 countries
The statistics are based on the number of cycles each unit performed and not on the number of units.
The total number of units that responded to the survey was 428, of which the computer analysis rejected 69 units due to incomplete data.
The below survey was suggested and conducted by:
Peng Cheang Wong,
The graph summarizes the number of units and yearly IVF cycles performed by those units per continent.
3. In most of the cycles hCG is given when the follicles are between 16 to 20 mm in diameter (92%). Only in the minority of the cycles it is given when the follicles are bigger. Almost no one waits for the follicles to reach 23-24mm in diameter.
4. In the majority of cycles hCG is given when at least three follicles reach the optimum diameter.
5. Recombinant hCG is administered in 57% of the cycles while urinary hCG is given in 41%. The most common dose is 6600 units of hCG (one ampoule of Ovitrelle). As for urinary hCG the most common dose is 10,000 IU of hCG.
6. No matter what drug is used during the stimulation, hCG is the most common drug used for for the final stage of oocyte maturation.
7. Ninety one percent do not monitor patients after hCG administration.
8. If monitoring is performed, follicles, estrogen and progesterone are examined.
9. In most of the cases the interval between hCG administration and egg collection is between 34-37 hours. The minority waits several more hours.
10. For those who use GnRH agonists to trigger endogenous LH, the interval between the drug administration and egg collection is similar in comparison with hCG.
11. In the majority of centers performing natural cycle IVF, hCG is given to trigger the final stage of oocyte maturation.
12. Light anesthesia is the preferred anesthesia for egg collection (56%). It is interesting to note that 9% of egg collections are done under local anesthesia.
13. In most cases, cleansing of the vagina is done with sterile water alone (73%).
14. In most cases the preferred aspiration needle to use in stimulated IVF cycles is a single lumen needle.
15. In only 42% of the aspiration cycles antibiotics are administered on a regular basis.
16. Antibiotics are given in most cases during the procedure as a single IV shot (38%).
17. The usual time between egg collection and discharge from the clinic is less than 2 ours (59%) in most cases.
18. In most of the cases hemoglobin measurements or an ultrsound scan are not performed before patient discharge.
19. It is interesting to reveal that most of women (57%) worldwide, are released from the clinic after egg collection following nurse inspection. Analyzing the data for the USA and Canada only revealed that following egg collection in 81% of cycles do nurses discharge the patients from the clinic.
20. There is no widely accepted method of cleaning the cervix before E.T. Both sterile water and medium serve the same purpose.
21. In most cases a Mock catheter is not used.
22. Ultrasound has became almost a rutine procedure in the process of E.T.
23. There is no agreement as to where the optimal position is to deposit the embryos within the uterus. In most of the cases the embryos are deposited in the lower part of the uterus (61%).
24. In most of the cases, even if there are difficulties in E.T. the procedure will be performed. In only 3% of cycles will embryos be frozen. The most popular technique in difficult transfers is utilization of the malleable stylette Catheter.
25. In difficult cases of E.T. 47% would prefer to dilate the cervix before the next cycle if the patient did not conceive.
26. During E.T. the majority ,75%, will delay the removal of the catheter from the uterus.
27. In most cycles (42%) patients are discharged immediately after E.T. Another 31% are discharged before 30 minutes is up. Only a minority of clinicians will keep the patients in supine position after E.T.
29. For IUI most of patients (55%) are kept in the supine position for 15 minutes.
30. In most of cases IUI is performed only once (74%) per stimulated cycle.