“How did it go?”—investigation of physician’s experience during embryo transfer and subsequent pregnancy outcomes

This research sought to investigate if a physician's experience of an embryo transfer (ET) correlates to rates of success. A single experienced physician rated characteristics of ETs including ease of transfer (1-10), visibility (1-10), presence of blood, and amount of mucus (0-3) at the time of ET. Main outcomes were positive beta-human chorionic gonadotropin level 11 days post transfer and ongoing pregnancy rate. A total of 365 transfers were rated. The average age of patients was 34.2 + / - 4.6 years. A total of 69.6% of cycles were programmed, and 73.2% of the transferred embryos underwent pre-implantation genetic testing for aneuploidy (PGT-a) prior to transfer. Average ease of transfer scores (9.3 + / - 1.7 vs 9.2 + / - 1.7; p = 0.71) and visibility scores (8.3 + / - 2.3 vs 8.1 + / - 2.8; p = 0.37) were similar between positive and negative pregnancy tests, respectively. Blood and mucus did not influence pregnancy rates. There was no correlation between ease of mock and actual embryo transfers. Multivariate logistic regression for positive bHCG demonstrated a significant predictive value for PGT-a (OR 2.50, 95% CI 1.47-4.23). Ease of transfer (OR 1.02, 95% CI 0.88-1.15), visibility (OR 1.04, 95% CI 0.94-1.15), mucus (OR 1.00, 95% CI 0.77-1.30), and embryo age (OR 0.98, 95% CI 0.92-1.03) were not predictive. In experienced hands, physician subjective impressions of transfer characteristics were not significantly correlated with a successful transfer.