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ASRM standard embryo transfer
protocol template: a
committee opinion
Practice Committee of the American Society for Reproductive Medicine American Society for Reproductive Medicine, Birmingham, Alabama
Standardization improves performance and safety. A template for standardizing the embryo transfer procedure is presented here with 12 basic steps supported by published scientific literature and a survey of common practice of SART programs; it can be used by ART prac- tices to model their own standard protocol. (Fertil SterilÒ 2017;107:897–900. Ó2017 by American Society for Reproductive Medicine.)
Discuss: You can discuss this article with its authors and with other ASRM members at https://www.fertstertdialog.com/users/ 16110-fertility-and-sterility/posts/15158-23913
The 2014 to 2019 American Soci- ety for Reproductive Medicine (ASRM) Strategic Plan is focused on seven goals. Two of those goals are: 1) setting new standards in the continuing medical education of, and, 2) having maximal impact on repro- ductive medicine. In response to accu- mulating evidence that suggested a gap in clinician training and standard- ization of the embryo transfer proced- ure, ASRM presents the results of an embryo transfer initiative in this issue of Fertility and Sterility. Prior reports have suggested that the majority of fel- lows in reproductive endocrinology and infertility training perform very few, if any, embryo transfers. In addi- tion, studies have consistently demon- strated that in vitro fertilization (IVF) pregnancy rates vary by the clinician performing the transfer (1–4).
ASRM formed an Embryo Transfer Advisory Panel to move this initiative forward. The panel collaborated with a leading medical simulation company, VirtaMed, to develop a virtual reality- based simulator for training in embryo transfer and intrauterine insemina-
tions. The panel also developed an extensive 82-question survey that was sent to all Society for Assisted Repro- ductive Technology (SART) medical di- rectors and was completed by 41% of them. The results of that survey are summarized in this issue in the article titled, ‘‘Embryo transfer techniques: an ASRM survey of current SART prac- tices’’ (5). Survey results were used to guide the development of the embryo transfer simulator and to determine common practices around embryo transfer. The results were also used to develop a ‘‘common practice’’ docu- ment that allows clinicians to review all of the steps of the embryo transfer procedure and better understand com- mon practice. The survey article can be used to identify variations in clinical practice and potential areas for change.
As part of the embryo transfer initia- tive, a subset of the Embryo Transfer Advisory Panel served as a special task force of the ASRM Practice Committee to perform a systematic review of the literature around the major steps of the embryo transfer procedure. The goal of this work was to identify those parts of the embryo transfer procedure that are
supported by the literature as well as gaps in research for which the literature is unable to provide guidance. A new ASRM guideline, ‘‘Performing the em- bryo transfer: a guideline,’’ summarizes the findings of that extensive review and is also published in this issue (6).
Figure 1 combines the findings of both the systematic review of the litera- ture and the embryo transfer survey of SART medical directors. In Figure 1 are 12 basic steps of the embryo transfer pro- tocol adopted by the ASRM Practice Committee. A number of the steps are supported by evidence in the literature and the new ASRM guideline on per- forming the embryo transfer (6). For those steps not supported by the litera- ture, data from the survey demonstrate common practice. While there are accept- able variations around some of the steps included here and the names given to some of the procedures may differ locally, the purpose is to fill a need for standard- ization. Literature on quality and safety is filled with evidence that standardization improves performance and safety (7). The embryo transfer survey paper dem- onstrates that only 50% of SART prac- tices responding had a standard embryo transfer protocol for all of their clinicians to follow. The ASRM Standard Embryo Transfer Protocol Template provides associated evidence for all practices to use to model their own standard protocol.
897
Received February 21, 2017; accepted February 21, 2017; published online March 11, 2017.
Reprint requests: Practice Committee, American Society for Reproductive Medicine, 1209 Montgom-
ery Hwy, Birmingham, Alabama 35216 (E-mail: ASRM@asrm.org).
Fertility and Sterility® Vol. 107, No. 4, April 2017 0015-0282/$36.00
Copyright ©2017 American Society for Reproductive Medicine, Published by Elsevier Inc. http://dx.doi.org/10.1016/j.fertnstert.2017.02.108
VOL. 107 NO. 4 / APRIL 2017
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