Causes and Effects of Oocyte Retrieval Difficulties: A Retrospective Study of 10,624 Cycles

Abstract

Oocyte retrieval is a routine procedure during the application of assisted reproduction technology. However, technical difficulties experienced during oocyte retrieval and the subsequent unsatisfactory number of oocytes obtained are rarely reported. The current study included 10,624 oocyte retrieval cycles from April 2015 to June 2018, and patients were followed up until February 2019. Patients were divided into two groups depending on whether the oocyte number obtained reached the >14-mm follicle number on the day of hCG administration. In the oocyte retrieval not satisfactory (ORNS) group, there were 1,294 cycles, and in the oocyte retrieval satisfactory (ORS) group, there were 9,330 cycles. ORNS patients were older, had a longer duration of infertility, had higher follicle-stimulating hormone, and were more likely to have endometriosis. The ORS group had a higher rate of the use of a follicular phase long-acting gonadotropin-releasing hormone (GnRH) agonist long ovarian stimulation protocol and a lower rate of the use of a luteal phase short-acting GnRH agonist long protocol. The ORNS group had fewer total number of days of FSH stimulation. On human chorionic gonadotropin day, the ORNS group had higher luteinizing hormone (LH), lower estradiol, and lower progesterone levels. After oocyte retrieval, the oocyte quality and fresh cycle transplantation rate were higher in the ORNS group. An unsatisfactory oocyte retrieval number did not influence the clinical pregnancy rate, miscarriage rate, or live birth rate during the fresh cycles. The cumulative pregnancy rate and the live birth rate were lower in the ORNS group. In conclusion, with a similar number of matured follicles, ORNS was more likely to occur in ovarian dysfunction patients. The follicular phase long-acting GnRH agonist long protocol had lower oocyte retrieval difficulty during IVF/ICSI. ORNS does not affect embryo quality or the fresh cycle pregnancy rate, but it significantly reduces the cumulative pregnancy rate and the live birth rate.

The Efficacy and Safety of Transvaginal Ethanol Sclerotherapy in the Treatment of Endometrial Cysts—A Systematic Review

“…Furthermore, this conclusion seems to be supported by a mostly beneficial effect of sclerotherapy on the number of oocytes retrieved compared to the effect exerted by laparoscopic cystectomy. This is a favorable outcome of sclerotherapy, particularly in light of reports indicating endometriosis as a factor able to impair the process of oocyte retrieval [51]. Additionally, in the course of the research, we observed rather a lack of differences in pregnancy outcomes between groups of patients who underwent sclerotherapy and those who underwent laparoscopic cystectomy or who were untreated.…”

Micro/Nanorobotics in In Vitro Fertilization: A Paradigm Shift in Assisted Reproductive Technologies

“…The microrobots, propelled by biological motors, exhibit enhanced maneuverability within the intricate reproductive anatomy, ensuring targeted oocyte retrieval while minimizing tissue trauma. These findings underscore the potential of micro/nano robots to redefine the landscape of oocyte retrieval in ART, offering novel solutions for addressing challenges associated with conventional retrieval techniques [45,49]. Through such innovations, micro/nano robots hold promise for enhancing the efficacy and patient satisfaction in ART procedures, paving the way for future advancements in reproductive medicine.…”

“…Advances in micro/nano robot-assisted oocyte retrieval have attracted scientific interest and have been published in scholarly journals [31,[45][46][47]. A work by Zhau et al (2021) [46] in the Journal of Chemical Reviews demonstrates the effective use of magnetic nanorobots for precise oocyte retrieval.…”

Risk factors for low oocyte retrieval in patients with polycystic ovarian syndrome undergoing in vitro fertilization

“…In our study, the progesterone level on the trigger day showed statistical significance in both the intergroup comparison and regression analysis; although the ROC analysis suggested that its predictive effect of a low ORR was not as strong as that of the E2/follicle ratio. Like estradiol, progesterone is a product secreted by ovarian granulosa cells, and the concentration of progesterone increases with the development of follicles and is positively associated with the number of oocytes [ 34 – 36 ]. It was found that both high and low progesterone levels in the late follicular phase resulted in reduced oocyte numbers [ 37 ].…”