Percutaneous oocyte retrieval from an inguinal ovary

Abstract

Ectopic locations of the ovary are rare, but should be considered when an ovary is absent on traditional imaging studies. The images presented are of a patient with recurrent pregnancy loss and infertility. Of note, she also had a corrected tetralogy of Fallot and normal karyotype. Hysterosalpingogram revealed a right unicornuate uterus with the presence and patency of only the right fallopian tube. Magnetic resonance imaging showed an absent left kidney and ovary and a left inguinal hernia. The left ovary was discovered on the seventh day of ovarian stimulation for in vitro fertilization when a mass was seen in the inguinal region (Fig. 1) with follicles visualized by transabdominal ultrasound. The risk of ovarian torsion was discussed with the patient who elected to continue the cycle. Oocyte retrieval was performed from the right ovary transvaginally. Then, using a transvaginal ultrasound probe with needle guide (Figs. 2 and 3), the needle was advanced percutaneously through the abdominal wall into the inguinal ovary allowing aspiration of normal-appearing oocytes. The patient did not conceive with the fresh transfer of a single blastocyst but conceived after a thaw transfer of a single embryo and delivered a healthy female at 34 weeks’ gestation. She plans to undergo corrective surgery to repair the inguinal hernia and reposition the ovary into the pelvic cavity.