Transvaginal ultrasound-directed oocyte retrieval for in vitro fertilization.

Abstract

Oocyte retrieval for in vitro fertilization and embryo transfer (IVF/ET) through the cul-de-sac under the guidance of a vaginal sector scanner was performed on 12 patients and compared with the previous laparoscopical oocytes retrieval for in vitro fertilization. Using a transvaginal sector scanner with puncture guide line, the needle was introduced through the posterior fornix of the vagina into the ovary. Vaginal sonography obviously has more benefits than the conventional laparoscopic method as the patients can be rid of the risk of repeated laparoscopy, can have less anesthetic and it is not necessary to have CO2 pneumoperitoneum, etc. When this method is compared with the transvesical approach, the transvaginal method does not require a full bladder, and has a shorter distance between the transducer and the follicles so it can provide better patient acceptability and better sonographic images which can increase the accumulated success rate. The recovery rate of oocytes was 8.83 per cycle which equals a mean recovery rate of 84%. The clinical pregnancy rate was 25% per retrieval cycle and 33.3% per embryo transfer. The results were not worse than those by laparoscopy and the transvesical method. This procedure is less time-consuming and has less blood loss than the other methods. We believe that, after a period of progression, IVF/ET can be performed in an outpatient setting with decreased risks and expenses of laparoscopy and general anesthesia.