Transabdominal ultrasound guided oocyte retrieval using vaginal ultrasound probe: Definition of the technique

Abstract

Purpose: To define whether transabdominal ultrasound guided oocyte retrieval (TUGOR) is a feasible, effective and safe method. Methods: A total of 64 patients who underwent TUGOR in a tertiary referral university hospital in vitro fertilization (IVF) clinic were enrolled. Indications, total number of oocytes collected, total number and percentage of mature oocytes, duration of procedure, complication rates and total number of fertilized oocytes were assessed. Results: The indications for TUGOR were as follows; virgin women with decreased ovarian reserve who opted fertility preservation (n = 52, 81.1%), Ewing Sarcoma (n = 1, 1.56%), breast cancer (n = 4, 6.2%), lymphoma (n = 1, 1.56%) endometrioma (n = 1, 1.56%), immature teratoma of the ovary (n = 1, 1.56%), multiple large uterine fibroids (n = 2, 3.1%), adnexal transposition due to bowel surgery (n = 1, 1.56%) and Mayer Rokitansky Küster Hauser Syndrome (n = 1, 1.56%). Total number of oocytes retrieved and mean number of oocytes collected were 315 and 4.92 AE 1.7 (range 1-21), respectively. The mean duration of the procedure was 12.4 AE 1.2 min. The number and percentage of mature oocytes were 272 and 86.3%, respectively. A total of 14 embryos were frozen in four patients and one blastocyst transfer was performed ending up with live birth. Superficial epigastric artery injury occurred in two patients and resolved spontaneously. No oocyte was retrieved in five patients with single growing follicle in the first attempt. Conclusion: TUGOR is a feasible, effective and safe method of oocyte retrieval for the purpose of fertility preservation or in patients with inaccessible ovaries via transvaginal route undergoing IVF.

The Effectiveness and Safety of Transabdominal Oocyte Pick-up Using a Vaginal Ultrasound Probe in Patients with Endometrioma Undergoing Oocyte Cryopreservation

“…Another essential step to follow is the application of continuous downward pressure to approximate the ovaries as close as possible with the tip of the implementing probe. In a previous paper which we described the procedure in an algorithmic approach, super cial epigastric artery injury occurred in two patients both of which resolved spontaneously [14]. However, both complications occurred in the initial cases before we optimized the procedure.…”

“…Final oocyte maturation was performed using a dual trigger method with 250 mg of recombinant hCG (Ovitrelle, Merck, Türkiye) and 0.2 mg of a GnRH analog (Gonapeptyl, Ferring Pharmaceuticals, Türkiye) as previously described by us when at least 2 follicles > 18 mm was observed [16]. All transabdominal oocyte pick-up procedures were performed according to an algorithmic approach as previously described by us elsewhere [14]. Oocyte pick-up procedures were performed using a 17-gauge double lumen oocyte retrieval needle (Cook Medical, Australia, and Geotek Healthcare Products, Türkiye) at 35.5 hours following ovulation trigger under inhalation anesthesia (Fig.…”

“…Nevertheless, a considerable proportion of these women do not wish to undergo vaginal oocyte retrieval due to cultural precepts and religious constrictions. In two previous reports, we demonstrated the safety of transabdominal oocyte retrieval using a vaginal probe in patients undergoing IVF for oocyte cryopreservation, and found it as similarly effective when compared with conventional vaginal oocyte pick up [14,15]. In this retrospective cohort study, we further aimed to analyze whether transabdominal oocyte retrieval is a safe and effective technique in single patients with endometrioma undergoing IVF for the purpose of oocyte cryopreservation.…”

Haemoperitoneum due to ovarian rupture after oocyte retrieval procedure

“…Techniques to perform this procedure have evolved overtime, and the gold standard today is TVOR 5. The technique consists of a transvaginal ultrasound probe accompanied by a needle guide for precise extraction of eggs within the ovaries via needle aspiration 6…”

The Effectiveness and Safety of Transabdominal Oocyte Pick up Using a Vaginal Ultrasound Probe in Patients with Endometrioma Undergoing Oocyte Cryopreservation

“…7 In two previous reports, we demonstrated the effectiveness and safety of transabdominal oocyte retrieval using a vaginal probe in patients undergoing IVF for oocyte cryopreservation. 8,9 In this retrospective cohort study, we further aimed to analyze whether transabdominal oocyte retrieval is a safe and effective tecnique in virgin patients with endometrioma undergoing IVF for the purpose of oocyte cryopreservation.…”