Factors such as catheter type, use of ultrasound, distance from fundus, time catheter remains in uterus, how slowly is it removed, use of the outer sheath, etc.
Well we use the cooks catheter with an outer sheath and an inner sheath and use a transabdominal ultrasonography with full bladder to watch it under supervision and although there re some conroversies but keeping a distance of about 1-3-1.5cm from fundus is helpful in preventing ectopic pregnancy and avoiding anylower implantation and keeping a small airbubble helps to know that u have deposited the embryo.s in corret position and normally we just wait to check that the catheter in inner sheath is empty that is we have deposited the embryos ,otherwise we dont need to keep the catheter inside and although some say bedrest for half hour helps -there is a joke that once embryos put in they cant be coughed out and it is proper placement which is important rather than waiting for long periods or bedrest and advantage of outersheath over wallace catheter which i found is sometimes accidentally despite having sdone a preop hysteroscopy and dilated cervix/tested for trial transfer catheter, you come across cases where suddenly there is difficulty in negotiating outer sheath and in those cases atleast one is prepared and embryos dont get exposed loaded in catheter,otherwise no otheradvantage of outer sheath.
Important for ET program is to prepare the donor before the superovluation technique. Ovarian status is very important. D10 of the estrous cycle is ideal for the induction of superovulation, The DF is in the final stage of activity and a new follicular wave is usually recruited by this time. Ablation of the DF may be also important before induction of the superovulation. Ultrasound may be help by the ablation technique.
Please watch the attached video, I'm sure you can learn enough from it: http://www.jove.com/video/50930/mouse-genome-engineering-using-designer-nucleases
Or, you can reading the "Manipulating the mouse embryo, A laboratory manual ", you will learn much more than you can imagine.
Good luck!
Dear Tarun,
We applied the mechanical pressure on the portiovaginalis of the cervix using the vaginal speculum during and after transferring the embryos for 5 minutes. It was published by R. Mansour (link).
Our implantation and pregnancy rates improved.
The best implantation rate is transfering euploid embryos analyzed by trophoectoderm biopsy and aCGH. We have a 60% implantation rate.
Best regards.
dear subhash we are getting approximately 50%implantation rates although currently we are not using any time lapse facility by which se hope to improve our successrates.and postponing to next cycles by cryppreserving all embryos will improve our implantation rates further but our patients do not afford the cryo preservation hence we are not currently doing elective ETS although one gets more physiological endometrium with estrogen and progesterone receptor status with implantation window being more perfect..
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