Effect of air bubbles localization and migration after embryo transfer on assisted reproductive technology outcome

Clinical pregnancy rates appear to be associated with the air bubble movement at 60 minutes after embryo transfer and movement toward the fundus is associated with more success.

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Volume 109, Issue 2, Pages 310–314.e1


Cem Fıçıcıoğlu, M.D., Ph.D., Pınar Özcan, M.D.'Correspondence information about the author M.D. Pınar ÖzcanEmail the author M.D. Pınar Özcan, Melis G. Koçer, M.D., Mert Yeşiladalı, M.D., Oya Alagöz, M.D., Gülçin Özkara, M.D., Ahter T. Tayyar, M.D., Çiğdem Altunok, M.D.



To evaluate the effect of embryo flash position and movement of the air bubbles at 1 and 60 minutes after ET on clinical pregnancy rates (PRs).


Prospective clinical trial.


University fertility clinic.


A total of 230 fresh ultrasound-guided ETs performed by a single physician (C.F.) at the IVF center of Yeditepe University Hospital between September 2016 and February 2017 were included.


Transabdominal ultrasonographic guidance at ET.

Main Outcome Measure(s)

Clinical PRs.


There was no significant difference in terms of clinical PRs between women with embryo flash located >15 mm and <15 mm from the fundus at 1 or 60 minutes (P=.6 and P=.7, respectively). The PRs in women with embryo flash located <15 mm and >15 mm from the fundus were 47% and 60%, respectively (P=.6). The clinical intrauterine PRs were 69.5%, 38.5%, and 19.1% in fundal, static, and cervical, respectively. The highest PR was in fundal when compared with others (P<.01). The clinical PR appears to be associated with the embryo flash movement/migration and the PR was dramatically reduced when the embryo migrated from its original position toward the cervix at 60 minutes.


We concluded that clinical PR appears to be associated with the embryo flash movement/migration at 60 minutes after ET and embryo flash movement toward the fundus is associated with higher clinical PRs. Further well-designed randomized controlled trials are required to optimize ET technique in the future.

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.