Egg Retrieval for in Vitro Fertilisation by Sonographically Controlled Vaginal Culdocentesis

Gleicher, Norbert; Friberg, Jan; Fullan, Neil; Giglia, RobertV.; Mayden, Kara L.; Kesky, Tom; Siegel, Israel

doi:10.1016/s0140-6736(83)90530-5

Cited by 112 publications

(31 citation statements)

References 3 publications

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“…Since the introduction of sonographically guided vaginal oocyte retrieval [11], a surprisingly small number of studies have attempted to optimize the technique. The introduction of thin needles, primarily designed for in-vitro maturation (IVM), offers an opportunity to revisit the question of whether oocyte retrieval can be improved, giving better oocyte yields, possibly by retrieving oocytes from small follicles, which may not be retrievable by standard size needles.…”

Section: Discussionmentioning

confidence: 99%

A pilot trial of large versus small diameter needles for oocyte retrieval

Kushnir

Kim

Gleicher

et al. 2013

Reprod Biol Endocrinol

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BackgroundThis study was designed to determine whether small diameter needles for oocyte retrieval alter oocyte yields in patients undergoing IVF in comparison to standard large diameter needles.MethodsWe conducted a prospective pilot study of 21 consecutive favorable prognosis patients. In each patient one ovary was randomly allocated to retrieval with either a 20 G/ 35 mm (thin) or 17 G/ 35 mm (standard) needle, the other ovary was then retrieved with the opposite needle.ResultsThe standard diameter needle was used to collect a total of 215 oocytes from 355 aspirated follicles (60.6%) compared to 203 oocytes from 352 aspirated follicles (57.7%) with the thinner needle (p = 0.23). Stratifying outcomes by anti-Müllerian hormone (AMH), as indicator of ovarian reserve, and by body mass index (BMI) the oocyte yields, still, did not differ (AMH, r (17) = −0.20, p = 0.44; BMI, r (17) =0.02, p = 0.96). Outcomes also did not vary among women with diminished ovarian reserve (p = 0.17) and in women with normal ovarian reserve (p = 1.00). Operating time was, however, significantly increased by 3.3 minutes per ovary (z = −3.08, p = 0.002) with the thinner needle.ConclusionsNeedle diameter does not affect oocyte yield, including in obese patients and patients with diminished ovarian reserve. Thinner needles appear to significantly prolong operating time.

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Section: Discussionmentioning

confidence: 99%

A pilot trial of large versus small diameter needles for oocyte retrieval

Kushnir

Kim

Gleicher

et al. 2013

Reprod Biol Endocrinol

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“…This study was very concerning but has never been reproduced. Ultrasound-guided oocyte aspiration for in vitro fertilization and embryo transfer was reported in the early 1980s [82,83]. It has now become routine [84].…”

Section: Ultrasound and The Ovummentioning

confidence: 99%

Ultrasound in the First Trimester and Earlier: How to Keep It Safe

Abramowicz

2016

First-Trimester Ultrasound

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1"Ultrasound is safe. Ultrasound is not X-rays. Our machines are FDA-approved." These are the statements most commonly made when initiating a conversation on safety of ultrasound. This is one of the reasons cited for its becoming an essential tool in medicine (together with its relatively low cost and immediate results availability). Diagnostic ultrasound (DUS) has been in use for over half a century in obstetrics and gynecology [1] and the benefits of this technology are multiple [2]. Most pregnant women have 2-3 ultrasound examinations (and many more in certain countries) during their pregnancies. In early pregnancy and before (i.e., in Artificial Reproductive Technologies [(ART]), these include serial scans of the developing follicles during ovulation induction [3] and in the earliest stages of gestation [4], first-trimester ultrasound for viability and/or aneuploidy screening (nuchal translucency, NT) and, more and more, early anatomy survey [5]. Such is the widespread enthusiasm and the generally accepted notion of safety that its use has spilled into the commercial world with mall stores offering non-medical ultrasound or "souvenir" scans. The record of safety of DUS is excellent: there are no epidemiological studies demonstrating harmful effects in human fetuses [6]. Most human epidemiological studies, however, published so far are based on information obtained with pre-1991/1992 machines. Around that time, the US Federal Drug Administration (FDA) allowed the acoustic output of ultrasound machines for fetal use to be increased from 94 to 720 mW/cm 2 , a factor of almost 8 [7,8]. Is there enough evidence to validate the use of ultrasound imaging in general and Doppler in particular in the first trimester [9] and could ultrasound have detrimental effects on the fetus in the first trimester, a time of maximal susceptibility to external factors? If there are clinical indications to perform these scans (and if there were none, there would be no raison-d'être for this book) safety must be guaranteed by educating the end-users on ways to limit the possible hazards of exposure of the follicles/ova and the fetus at early stages of gestation [2].

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“…The findings of this report highlight the risk of complications after transvaginal invasive procedures with the use of needles and demonstrate the importance of hygiene procedures, the need to employ a needle for each procedure and the importance of a trained person to perform a safe procedure. KEYWORDS: Bovines, ovary, reproduction, ultrasonography, transvaginal technique, TruCut needle INTRODUÇÃO O emprego de técnicas transvaginais para coleta de material ovariano foi relatado pela primeira vez em estudos voltados à colheita de oócitos para a realização de fertilização in-vitro (FIV) em mulheres inférteis (GLEICHER et al, 1983;DELLENBACH et al, 1984). Nas vacas, também com a mesma finalidade, o acesso ovariano por via transvaginal com auxílio de ultrassonografia começou a ser empregado na década seguinte (PIETERSE et al, 1991) e hoje é uma prática amplamente difundida.…”

Section: Peritonitis After Ultrasonography Guided Biopsy Of Corpus Luunclassified

Peritonite Após Biópsia De Corpo Lúteo Guiada Por Ultrassonografia Em Vacas Da Raça Holandesa: Relato De Caso

Dalanezi¹,

García²,

Ferrazza³

et al. 2015

Enciclopédia Biosfera

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RESUMOEm bovinos, os procedimentos invasivos ovarianos transvaginais, empregados com finalidades diagnósticas, biotecnológicas ou experimentais, mesmo sendo práticas consolidadas, podem apresentar complicações posteriores. Este relato tem como objetivo apresentar complicações observadas em três fêmeas bovinas da raça Holandesa submetidas à biópsia de corpo lúteo (CL) pela técnica transvaginal guiada por ultrassonografia, empregando-se agulha Tru-cut (18G x 48 cm). No segundo dia após o procedimento, os animais começaram a apresentar sinais característicos de peritonite, como leucocitose, neutrofilia, hiperfibrinogenemia, acúmulo de fluido intra-abdominal e aderências do útero e ovários às vísceras circunvizinhas. Como o prognóstico desta afecção é ruim ou reservado, as vacas foram eutanasiadas e necropsiadas. Os principais achados post mortem foram: hidroperitôneo, peritonite fibrinosa difusa, ooforite fibrinosa associada a múltiplos cistos ovarianos, acúmulo de líquido seroso/purulento abundante no útero e múltiplos cistos aderidos à serosa intestinal, além de aderências intestinais ao ovário. Como o grau de comprometimento peritoneal era decrescente e pelo fato dos animais acometidos terem sido submetidos à biópsia de CL sequencialmente no mesmo dia, com a mesma agulha, suspeitou-se que no primeiro animal pode ter ocorrido o acidente primário que resultou na contaminação fecal da agulha, sendo disseminada para os demais animais. Os achados do presente relato demonstram o risco de ocorrência de complicações após procedimentos invasivos de fundo vaginal com o emprego de agulhas e sinalizam a importância dos cuidados de higiene, da troca da agulha e a necessidade de experiência do operador para a realização segura da técnica.

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Egg Retrieval for in Vitro Fertilisation by Sonographically Controlled Vaginal Culdocentesis

Cited by 112 publications

References 3 publications

A pilot trial of large versus small diameter needles for oocyte retrieval

A pilot trial of large versus small diameter needles for oocyte retrieval

Ultrasound in the First Trimester and Earlier: How to Keep It Safe

Peritonite Após Biópsia De Corpo Lúteo Guiada Por Ultrassonografia Em Vacas Da Raça Holandesa: Relato De Caso

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