Mark A Damario1. 1. Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota 55905, USA. damario.mark@mayo.edu
Abstract
OBJECTIVE: To describe the approach of transabdominal-transperitoneal ultrasound-guided oocyte retrieval undertaken in a patient with müllerian agenesis and ovarian malposition who underwent a successful gestational carrier treatment cycle. DESIGN: Case report. SETTING: A tertiary-referral reproductive medicine unit. PATIENT(S): A 26-year-old patient with müllerian agenesis. Her 44-year-old mother served as the gestational carrier. INTERVENTION(S): Controlled ovarian hyperstimulation, transabdominal-transperitoneal ultrasound-guided oocyte retrieval, embryo transfer. MAIN OUTCOME MEASURE(S): Oocyte recovery rate, fertilization rate, pregnancy test. RESULT(S): Six oocytes were retrieved using a percutaneous transperitoneal needle puncture under ultrasound guidance. Two cleavage-stage embryos were transferred to the gestational carrier, resulting in a twin pregnancy. CONCLUSION(S): For various reasons, patients with müllerian agenesis may not be candidates for standard transvaginal ultrasound-guided oocyte retrieval. Although laparoscopic oocyte retrieval has been frequently used in this setting, the approach of transabdominal-transperitoneal ultrasound-guided oocyte retrieval may offer further advantages in select cases.
OBJECTIVE: To describe the approach of transabdominal-transperitoneal ultrasound-guided oocyte retrieval undertaken in a patient with müllerian agenesis and ovarian malposition who underwent a successful gestational carrier treatment cycle. DESIGN: Case report. SETTING: A tertiary-referral reproductive medicine unit. PATIENT(S): A 26-year-old patient with müllerian agenesis. Her 44-year-old mother served as the gestational carrier. INTERVENTION(S): Controlled ovarian hyperstimulation, transabdominal-transperitoneal ultrasound-guided oocyte retrieval, embryo transfer. MAIN OUTCOME MEASURE(S): Oocyte recovery rate, fertilization rate, pregnancy test. RESULT(S): Six oocytes were retrieved using a percutaneous transperitoneal needle puncture under ultrasound guidance. Two cleavage-stage embryos were transferred to the gestational carrier, resulting in a twin pregnancy. CONCLUSION(S): For various reasons, patients with müllerian agenesis may not be candidates for standard transvaginal ultrasound-guided oocyte retrieval. Although laparoscopic oocyte retrieval has been frequently used in this setting, the approach of transabdominal-transperitoneal ultrasound-guided oocyte retrieval may offer further advantages in select cases.
Authors: Benjamin Jang; Aaron Rohr; Paras P Vakharia; Zachary Collins; Courtney Marsh; Isabella Herrera; Thomas Fahrbach Journal: Fertil Res Pract Date: 2019-04-02