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Objectives:To evaluate whether the site of embryonic deposition after embryo transfer (ET), as assessed by air bubble location after embryo transfer (ET) , is associated with clinical outcome.Method Our study is a retrospective chart review.5082 ET cycles of 3504 patients who started treatment at the clinic between Jan 2011 and Jan 2013 and were tested for absence or presence of the following: negative blood/urine pregnancy test, early spontaneous abortion, ectopic/heterotopic pregnancy, late-term abortion, or live birth were under retrospective chart review mainly analyzing distance from air bubble after ET to fundal endometrial surface and the pregnancy outcome.Data collected includes basal characteristics (age, body mass index, basal follicle-stimulating (FSH)) and clinical outcome (negative urine/blood tes, ectopic pregnancy, early spontaneous abortion, late-term abortion or live birth).Results A total of 5082 US-guided ET were performed.The PR in the whole population was 43.98% (2235/5082) and live birth rate was 35.44% (1801/5082).In fresh ET cycles (N =3214) with cleavage-stage embryos, the clinical pregnancy rate (CPR) ,implantation rate (IR) and baby take-home rate of (THR) of Group A (≤ 10 mm, N=1619) were reduced compared to Group B (>10mm, N=1595) (46.16%vs.50.28%,P=.016;30.30%vs.32.64%,P =.035;and 37.00% vs.43.82%, P =.004, respectively) , while the ectopic pregnancy rate (ER) was significantly higher (4.30% vs.2.24%, P =.023).Basal characteristics (age, body mass index, basal FSH)and ART protocol are balanced between groups except for endometrial thickness on HCG day (Group A 10mm) (54.32% vs.36.00%, P =.045;43.40% vs.23.08%, P =.000;and 49.38% vs.29.33%, P =.011, respectively).Basal characteristics (age, body mass index, basal FSH) and ART protocol are balanced between groups except for endometrial thickness on HCG day (Group C10mm, N =553)(18.91% vs.21.94%, P =.024), CPR(35.01% vs 38.52%,P =.165)and THR (26.74% vs 29.84%,P =.188)were similar between group.ER of Group E was significantly higher than Group F (4.89% vs 0.47%, P =.004), EAR(13.86% vs 18.31%, P =.153)and LAR(5.71% vs 4.23%, P =.437)were comparable between groups.In FET cycles with blastocyst (N =108), CPR, IR, THR, ER, EAR and LAR of Group G (≤ 10mm,N =66) and Group H (> 10mm, N =42) were not significantly different.Conclusion A favorable clinical outcome was associated with a greater distance from the site of embryonic deposition to fundus for cleavage-stage embryos, while with a shorter distance for blastocyst-stage embryos.Ectopic pregnancy rate reduced as the distance from fundal endometrial surface was longer.Distance from fundus were not associated with early abortion or late-term abortion.