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REVIEW  HOT TOPICS IN HUMAN ASSISTED REPRODUCTION: PERFECTING THE ART OF ART Free accessfree

Panminerva Medica 2022 June;64(2):185-99

DOI: 10.23736/S0031-0808.22.04679-1

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Clinical aspects of oocyte retrieval and embryo transfer: tips and tricks for the novice and the expert

Hassan N. SALLAM 1 , Tarek A. GELBAYA 2, Israel MALDONADO ROSAS 3, Christina ANAGNOSTOPOULOU 4, Nooman SALLAM 5, Ashok AGARWAL 6

1 Department of Obsterics and Gynaecology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt; 2 Department of Obstetrics and Gynecology, University Hospitals of Leicester, Leicester, UK; 3 Citmer Reproductive Medicine, IVF Lab, Mexico City, Mexico; 4 Reproductive Medicine Unit - Embryo ART, Lito Maternity Hospital, Athens, Greece; 5 Department of Obstetrics and Gynaecology, Guy’s and St Thomas’ NHS Trust, London, UK; 6 Andrology Center and American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA



Oocyte retrieval (ovum pick-up) and embryo transfer (ET) are essential steps in in-vitro fertilization and intracytoplasmic sperm injection and over the years, the two procedures were developed in order to improve the clinical outcome. Many suggestions were proposed and applied before, during and after oocyte retrieval such as timing of HCG trigger, pre-operative pelvic scan, vaginal cleansing, type of anesthesia, type and gauge of aspiration needles, aspiration pressure, follicle flushing, and the need for prophylactic antibiotics. Similarly, many steps were suggested and implemented before, during and after ET including patient’s position, type of anesthesia/analgesia, dummy (mock) ET, ultrasound-guidance, HCG injection in the uterine cavity, use of relaxing agents, full bladder, removal of the cervical mucus, flushing the cervix with culture medium, type of ET catheter, embryo loading techniques, site of embryo deposition, the use of adherence compounds, as well as bed rest after ET. Complications were also reported with oocyte retrieval and ET. The aim of this review is to evaluate the current practice of these two procedures in the light of available evidence.


KEY WORDS: Oocyte retrieval; Embryo transfer; Fertilization in vitro; Intracytoplasmic sperm injections; Reproductive techniques

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