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A prospective study comparing the outcome of oocytes retrieved in the aspirate with those retrieved in the flush during transvaginal ultrasound directed oocyte recovery for in‐vitro fertilization
Author(s) -
HUSSEIN ELSIR,
BALEN ADAM H.,
TAN SEANGLIN
Publication year - 1992
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1992.tb14417.x
Subject(s) - oocyte , andrology , human fertilization , embryo transfer , in vitro fertilisation , embryo , cryopreservation , follicular phase , pregnancy rate , embryo cryopreservation , biology , gynecology , pregnancy , medicine , anatomy , endocrinology , genetics , microbiology and biotechnology
Objective To study prospectively the fate of oocytes collected from the follicular aspirate and subsequent flushes during transvaginal ultrasound directed oocyte recovery for in‐vitro fertilization (IVF). Setting A tertiary referral assisted conception centre. Subjects 100 consecutive patients undergoing 100 cycles of IVF. Four patients were withdrawn because their embryos were electively cryopreserved. Therefore 96 cycles were studied. Main outcome measures The oocyte recovery rate, viability, fertilization and cleavage rates and outcome of embryos generated from oocytes that were obtained from either the initial aspirate (Al), dead space in the collecting system (A2) or the first two 2 ml flushes (Fl and F2) were compared. Results The overall oocyte recovery rate was 87.8%. Of the 1046 oocytes collected, 40.3% were from Al, 41.3% from A2, 13.7% from Fl and 4.7% from F2. There were comparable numbers of viable and fertilized oocytes and cleaved, transferred and frozen embryos in tubes Al and A2 but all these parameters were significantly lower in tubes Fl and F2 (P<0.0001). All these parameters were also significantly higher in Fl compared with F2 (P<0.001), except for the number of embryos frozen, in which there was no difference. The overall pregnancy rate per cycle was 28.1% and the pregnancy rate per embryo transfer was 31.0%. There were no pregnancies in any of the cycles in which embryos originating from F2 were transferred, nor were there pregnancies in cycles in which only embryos from Fl were transferred. Conclusion Follicular aspiration together with one 2 ml flush maximises the recovery of oocytes that will result in pregnancies.