Training on transabdominal ultrasound guidance during embryo transfer and proficiency evaluation of training

Background: Embryo transfer (ET) is the crucial and final step in in-vitro fertilisation (IVF) process which has major impact on IVF outcome. ET technique has been standardized at present and done under ultrasound guidance. But there are no standardised steps described for the transabdominal ultrasound guidance during ET. Aims: To define the steps of transabdominal ultrasound guidance during ET using a training module; to evaluate the proficiency and learning curve of training; and to assess the impact on trial ET performance after training. Settings and design: A prospective study was conducted in a tertiary assisted reproductive technology (ART) centre, northern India between August 2018 and February 2019. Materials and methods: Ultrasound guidance during trial ET was evaluated for 12 doctors who participated in the study on 234 patients. Ultrasound guidance evaluation included scores for USG assessment of trajectory, catheter type prediction, difficulty prediction, ultrasound visualisation during trial ET and trial ET performance. Transabdominal ultrasound guidance training was given to all doctors after 10 pre-training evaluations followed by post-training evaluations. Pre- and post-training mean scores for each doctor and overall were compared using SPSS-21. Results: Mean scores showed improvement in all parameters, including trial ET performance for the doctors included in study. Overall, these differences were statistically significant. six doctors (50%) were declared trained in transabdominal ultrasound guidance during trial ET. Conclusion: The training module was effective in defining the steps of transabdominal ultrasound guidance during trial ET and improving the trial ET performance.