Does Unilateral Oocyte Retrieval due to Transvaginally Inaccessible Ovaries, Contrary to Common Beliefs, Affect IVF/ICSI Treatment Outcomes That Much?

Safak Olgan,Sezcan Mumusoglu,Gurkan Bozdag

doi:10.1155/2016/3687483

Safak Olgan, Sezcan Mumusoglu + Show 1 more

Open Access

https://doi.org/10.1155/2016/3687483

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Abstract

Objective. To investigate in vitro fertilization (IVF) treatment outcomes of unilateral oocyte retrieval in patients with transvaginally inaccessible ovaries. Study Design. Ninety-two women who underwent unilateral oocyte retrieval were retrospectively matched for age, antral follicle count, and body mass index with 184 women who underwent bilateral oocyte retrieval. Each patient in bilateral oocyte retrieval group had the same number of cumulus oophorus complexes (COCs) from single ovary and had comparable number of follicles (±2) on contralateral site where follicular aspiration was performed. Results. The number of COCs, metaphase-2 oocytes, 2-pronuclei, and top-quality embryos was significantly lower in unilateral oocyte retrieval group. However, proportion of patients with an embryo transfer of at least one top-quality embryo was found to be comparable between unilateral and bilateral oocyte retrieval. Subsequently, clinical pregnancy and live birth rates were found to be similar between the groups. The ROC curve analysis revealed (AUC = 0.74, 95% CI 0.63–0.86, p = 0.001) that retrieved COCs ≥ 5 from single ovary had sensitivity of 76.0% and specificity of 64.2% for occurrence of a clinical pregnancy. Conclusion. The patients with unilateral oocyte retrieval have reasonable chance of success with IVF. The retrieval of ≥5 COCs from accessible ovary might result in better treatment outcomes among these patients.

Highlights

Ovarian stimulation is an important part of assisted reproduction treatment (ART)
There is the possibility of the underreporting of complications, and this may be attributed to the rare nature of this event and to the fact that many in vitro fertilization (IVF) treatment providers may be less interested in reporting complications because the major scientific focus is on IVF-intracytoplasmic sperm injection (ICSI) outcomes
There was no significant difference in age, body mass index (BMI), antral follicle count, duration of infertility, prior pregnancy, number of previous unsuccessful attempts at IVF, polycystic ovaries at ultrasound, presence of endometriosis, and poor ovarian reserve between the groups (p > 0.05 for each)

Summary

Introduction

Ovarian stimulation is an important part of assisted reproduction treatment (ART). This regimen is used to stimulate multiple follicle development in a single cycle [1]. Increasing the number of mature oocytes suitable for IVF procedures improves the likelihood of generating good quality embryos and of achieving a successful pregnancy [1, 2]. Transvaginal oocyte retrieval, under ultrasound guidance, is the current method of choice for oocyte retrieval in IVF and intracytoplasmic sperm injection (ICSI) [5]. It is generally a safe and a well-tolerated procedure associated with a low overall complication rate, commonly cited at less than 5%. There is the possibility of the underreporting of complications, and this may be attributed to the rare nature of this event and to the fact that many IVF treatment providers may be less interested in reporting complications because the major scientific focus is on IVF-ICSI outcomes

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