BACKGROUND: Ultrasound-guided transvaginal follicular aspiration is the standard of care in women undergoing oocyte retrieval during vitro fertilization (IVF). When this approach is inaccessible, there are alternative methods to extract the oocytes at the exact moment. One of these alternative options is the transabdominal ultrasound-guided follicular aspiration. We present a case report of a mixed follicular aspiration in a patient with ovaries of difficult access. CASE REPORT: A 36-year-old patient with primary infertility came for medical advice. Because of bilateral tubal occlusion, an in vitro fertilization cycle was started. Transvaginal sonograms revealed a normal left ovary, but the right one was completely attached to the anterior face of the uterus. After ovarian stimulation, transvaginal follicular aspiration was done on the left ovary, meanwhile, on the right ovary; transabdominal follicular aspiration was performed, retrieving 3 oocytes on metaphase II by this technique. Finally, there were no complications during the procedure and the patient got pregnant at the end of the treatment. CONCLUSIONS: Ultrasound-guided transabdominal follicular aspiration, is the safest and most effective technique when transvaginal access to the ovaries is compromised.
BACKGROUND: Ultrasound-guided transvaginal follicular aspiration is the standard of care in women undergoing oocyte retrieval during vitro fertilization (IVF). When this approach is inaccessible, there are alternative methods to extract the oocytes at the exact moment. One of these alternative options is the transabdominal ultrasound-guided follicular aspiration. We present a case report of a mixed follicular aspiration in a patient with ovaries of difficult access. CASE REPORT: A 36-year-old patient with primary infertility came for medical advice. Because of bilateral tubal occlusion, an in vitro fertilization cycle was started. Transvaginal sonograms revealed a normal left ovary, but the right one was completely attached to the anterior face of the uterus. After ovarian stimulation, transvaginal follicular aspiration was done on the left ovary, meanwhile, on the right ovary; transabdominal follicular aspiration was performed, retrieving 3 oocytes on metaphase II by this technique. Finally, there were no complications during the procedure and the patient got pregnant at the end of the treatment. CONCLUSIONS: Ultrasound-guided transabdominal follicular aspiration, is the safest and most effective technique when transvaginal access to the ovaries is compromised.
Authors: Benjamin Jang; Aaron Rohr; Paras P Vakharia; Zachary Collins; Courtney Marsh; Isabella Herrera; Thomas Fahrbach Journal: Fertil Res Pract Date: 2019-04-02