06 Jan Process of Oocyte retrieval in ART labs

Here at IIRFT, a leading fertility institute in India, we aspire to become the leaders in spreading knowledge about assisted reproductive technology (ART). Today, we are going to talk on Oocyte retrieval procedure.

Simply put, Oocyte retrieval is an easy method of collecting eggs from female’s ovaries and is a vital procedure in in-vitro fertilization (IVF) in order to achieve fertilization in ART lab.

(a) Laparoscopic oocyte retrieval: The methods used for oocyte retrieval have made considerable progress in the last 30 years. Use of sonographically-guided retrieval of human oocytes for IVF was introduced by Lenz et al in 1981. In early 80s, oocytes were retrieved by the trans-abdominal route. Later trans-vesical, trans-rectal and trans-vaginal approach was introduced. By the end of the decade, trans-vaginal aspiration became well-accepted and is now the most widely used procedure all over the world.

(b) Preparation of Oocyte retrieval: The success of oocyte retrieval is dependent on good visualization and accessibility of both ovaries and on the materials and methods used for oocyte collection. Accurate information from pre-treatment laparoscopic findings is essential when deciding whether laparoscopic or other routes should be used.

This technique is indicated when the ovaries are out of reach with the trans-vaginal approach. This could be because of their elevated position in the pelvis, being behind the uterus r when the ovaries are too mobile. This procedure requires general anesthesia and endotracheal intubation, which is one of the major disadvantages of this technique.

The patient is instructed to do fasting 34-35 hours prior to administration to hCG.

The patient is given premedication and is placed in a modified dorsal lithotomy position in the operation table.

The ultrasound machine is placed next to the patient’s pelvis on the right/left hand side of the surgeon who operates from between the patients legs. The machine is connected to the video monitor. The vagina is cleaned with normal saline.

A sterile vaginal probe with the attached needle guide is introduced in the vagina.

The pelvis is scanned and the follicles are visualized. The needle is introduced inside the closest follicle and is aspirated. A negative pressure of 120 mm Hg is applied with an automatic suction machine operated with foot pedal. The remaining follicles are also similarly aspirated. The procedure is repeated with the other ovary. When all follicles have been aspirated, the pouch of Douglas is inspected for any fluid collection. Fluid if any is aspirated trans-vaginally and checked for any spontaneously ovulated oocytes. The vaginal vault is swabbed and checked for any bleeding. After individual retrieval, the trans-vaginal probe is cleaned with warm-soapy water, rinsed and dried.

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