Rectal Ultrasound (TRU) in Embryo Transfer (ET) for ICSI in Specific Populations

Document Type : Review article

Authors

1 Bedaya Hospital

2 Department of Obs&Gyn. Faculty of Medicine - Cairo University

Abstract

Intracytoplasmic sperm injection (ICSI) has revolutionized assisted reproductive technologies (ART), with embryo transfer (ET) being a pivotal determinant of success. However, specific patient populations—including those with retroverted uteri, cervical stenosis, obesity, or uterine anomalies—face unique anatomical and physiological challenges that compromise traditional ET techniques. Transabdominal (TAUS) and transvaginal ultrasound (TVUS), while widely used, often provide suboptimal visualization in these cases, leading to reduced implantation and pregnancy rates. Rectal ultrasound (TRU) has emerged as a novel imaging modality, offering enhanced visualization of the uterine cavity and catheter trajectory in complex scenarios. Preliminary studies, such as those by Roig Navarro et al. (2020) and Abu-Dahab et al. (2021), underscore TRU’s potential to overcome anatomical barriers, yet its integration into clinical practice remains limited. This review synthesizes evidence from randomized controlled trials (RCTs) and meta-analyses to evaluate TRU’s efficacy, address methodological limitations, and explore its role in improving outcomes for high-risk populations undergoing ICSI

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