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

Panminerva Medica 2022 June;64(2):156-70

DOI: 10.23736/S0031-0808.22.04675-4

Copyright © 2022 EDIZIONI MINERVA MEDICA

lingua: Inglese

Optimizing embryological aspects of oocyte retrieval, oocyte denudation, and embryo loading for transfer

Israel MALDONADO ROSAS 1, Christina ANAGNOSTOPOULOU 2, Neha SINGH 3, Nivita GUGNANI 4, Keerti SINGH 5, Dimple DESAI 6, Mahsa DARBANDI 7, 8, Madhumita MANOHARAN 9, Sara DARBANDI 7, 8, Annapoorani CHOCKALINGAM 10, Sofia I. LEONARDI DIAZ 11, Sajal GUPTA 12, Shinnosuke KURODA 12, Renata FINELLI 12, Hassan N. SALLAM 13, Kelly A. WIRKA 14, Florence BOITRELLE 15, 16, Ashok AGARWAL 12

1 Citmer Reproductive Medicine, IVF LAB, Mexico City, Mexico; 2 Unit of Reproductive Medicine - Embryo ART, Lito Maternity Hospital, Athens, Greece; 3 NOVA IVF, Gorakhpur, India; 4 Milann - The Fertility Center, New Delhi, India; 5 Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados; 6 DPU IVF and Endoscopy Center, Dr. D. Y. Patil Hospital & Research Centre, Pune, India; 7 Fetal Health Research Center, Hope Generation Foundation, Tehran, Iran; 8 Gene Therapy and Regenerative Medicine Research Center, Hope Generation Foundation, Tehran, Iran; 9 AlphaLife Fertility and Women’s Center, Salem, India; 10 Gene2Genome, Jacksonville, FL, USA; 11 Public Mother and Child Hospital, Salta, Argentina; 12 American Center for Reproductive Medicine, Cleveland, OH, USA; 13 Department of Obstetrics and Gynecology, Faculty of Medicine, Alexandria University, Alexandria, Egypt; 14 Fertility and Endocrinology, Medical Affairs, EMD Serono, Rockland, MA, USA; 15 Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France; 16 Department of Biology, Reproduction, Epigenetics, Environment and Development, Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas, France



Oocyte retrieval, oocyte denudation, and embryo transfer are crucial processes during assisted reproduction technology (ART). Air quality in the ART laboratory, temperature, pH of the media used and the time interval between oocyte retrieval and insemination are all critical factors. Anesthesia is required for oocyte retrieval, however, evidence regarding the potential impact of different methods (general anesthesia, conscious sedation, and local anesthesia) on the clinical outcomes is unclear. The optimal timing of oocyte denudation following retrieval has not been established. Regarding the mechanical denudation process, there is a lack of evidence to demonstrate the safest minimum inner diameter of denuding pipettes used to complete the removal of granulosa cells surrounding the oocytes. During embryo transfer, many clinics worldwide flush the catheter before embryo loading, in an attempt to potentially rinse off any toxic agents; however, there is insufficient evidence to show that flushing the embryo transfer catheter before loading increases the success of ART outcome. Considering the serious gaps in knowledge in ART practice, the aim of this review is to provide an updated overview of the current knowledge regarding the various steps and techniques involved in oocyte retrieval, oocyte denudation, and embryo loading for transfer.


KEY WORDS: Embryo; Oocyte retrieval; Oocyte denudation; Embryo transfer

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