Abstract:

In the process of assisted reproductive treatment, when ovarian visualization is not possible with transvaginal ultrasound and oocyte retrieval via transvaginal approach is difficult, the transabdominal ultrasound-guided oocyte retrieval is a safe and effective alternative option. We report two cases of transabdominal oocyte retrieval. One patient with congenital anal atresia had a vaginal stoma created due to prolonged fecal infiltration, with a high risk of infection during vaginal egg retrieval. The ovaries could not be palpated vaginally; therefore, oocyte retrieval was performed under transabdominal ultrasound guidance. Another patient with multiple uterine fibroids; with an enlarged uterus, who had the right ovary inaccessible via vaginal ultrasound; therefore, the combined transvaginal and transabdominal ultrasound-guided oocyte retrieval was performed. Both procedures resulted in the successful oocyte retrieval and the formation of transplantable embryos, suggesting that for those patients with ovaries inaccessible via vaginal examination and who experienced difficulties with vaginal oocyte retrieval, the transabdominal oocyte retrieval may significantly improve the chances of obtaining oocytes and embryos, thus improve the outcomes of assisted reproduction. This technique is safe and highly operable, but preoperative evaluation of oocyte retrieval should be emphasized in clinical practice to fully anticipate the difficulty of oocyte retrieval. Multidisciplinary discussions involving radiology and other relevant departments, along with thorough communication with the patient, as to minimize the possible medical disputes.

Key words: Fertilization in vitro, Embryo transfer, Transabdominal ultrasound-guided oocyte retrieval, Ovulation induction, Ultrasonography