Abou-Setta Ahmed M
Acta Obstet Gynecol Scand. 2007;86(5):516-22. doi: 10.1080/00016340701252126.
Part of the success of ultrasound-guided embryo transfer has been associated with the beneficial effect of uterine straightening by passive bladder distention. Even so, this has not been properly analysed in the literature.
This is a systematic review and meta-analysis of prospective, randomised, controlled trials, comparing embryo transfer with a full versus empty bladder. Electronic (e.g. PubMed, EMBASE, Cochrane Library) and hand searches were performed to locate trials. Primary outcomes were live-birth, ongoing and clinical pregnancy rates. Secondary outcomes were rates of implantation, miscarriage, multiple and ectopic pregnancies, and retained embryos. Also, the ease of transfer, need for instrumental assistance, and presence of blood on the catheter tip were evaluated. Four studies were identified, of which 1 study was excluded. Meta-analysis was conducted with the Mantel-Haenszel method, utilising the fixed-effect model.
For the primary outcome measures, no data was available for the LBR rate. There was a significantly higher chance of an ongoing pregnancy [OR=1.44 (95% CI=1.04-2.04)] and clinical pregnancy [OR=1.55 (95% CI=1.16-2.08)] with a full bladder. For the secondary outcomes, there was a significantly greater incidence of difficulty, or need for instrumental assistance, with an empty bladder. Other outcome measures were not significantly different.
There is evidence in the literature advising to fill the bladder prior to embryo transfer.
超声引导下胚胎移植的部分成功与被动膀胱充盈使子宫伸直的有益效果有关。即便如此，文献中对此尚未进行恰当分析。
这是一项对前瞻性、随机、对照试验的系统评价和荟萃分析，比较了膀胱充盈与排空时的胚胎移植情况。通过电子检索（如PubMed、EMBASE、Cochrane图书馆）和手工检索来查找试验。主要结局为活产、持续妊娠和临床妊娠率。次要结局为着床率、流产率、多胎妊娠率、异位妊娠率和胚胎残留率。此外，还评估了移植的难易程度、器械辅助的需求以及导管尖端有无血液。共识别出4项研究，排除其中1项。采用Mantel-Haenszel方法并利用固定效应模型进行荟萃分析。
对于主要结局指标，活产率无可用数据。膀胱充盈时持续妊娠[比值比（OR）=1.44（95%可信区间（CI）=1.04 - 2.04）]和临床妊娠[OR=1.55（95%CI=1.16 - 2.08）]的可能性显著更高。对于次要结局，膀胱排空时困难或器械辅助需求的发生率显著更高。其他结局指标无显著差异。
文献中有证据建议在胚胎移植前充盈膀胱。
