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Sadek S, Ramadan H, Matitashvili T, Stadtmauer L. To curette or not to curette; efficiency of oocyte retrieval technique. Arch Gynecol Obstet 2022; 306:1771-1776. [PMID: 36066617 DOI: 10.1007/s00404-022-06695-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/26/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE Follicular curetting is the gentle and rapidly rotating movement of the aspiration needle in a clockwise and counterclockwise fashion. The aim of our study is to assess this retrieval technique comparing cycle and pregnancy outcomes between curetting and non-curetting. METHODS This was a retrospective review of 817 patients that underwent oocyte retrieval at our fertility center from January 1st, 2016 until August 31st, 2019. All patients enrolled in the study underwent standard ovarian stimulation protocols. Three physicians routinely utilized follicle curetting during oocyte retrieval, while a fourth physician did not curette. Retrievals and embryo transfers were performed based on a rotating physician schedule. RESULTS Retrievals that were performed using a curetting technique had a significantly higher number of total oocytes retrieved 12.4 ± 8.1 vs 10.7 ± 7.5 (p = 0.01), and number of M2 oocytes retrieved 8.1 ± 6.4 vs 6.9 ± 6.0 (p = 0.03), resulting in an increased M2 oocyte yield 63.7% ± 41.3 vs 50.9% ± 30.6 (p = 0.0001). These patients also had a significant increase in clinical pregnancy rate per retrieval 55 vs 41% (p = 0.0016), live birth rate per retrieval 42 vs 34% (p = 0.04) and with no significant difference in multiple gestations or OHSS. CONCLUSIONS A significant improvement in clinical pregnancy rates and live birth per retrieval was detected in patients undergoing curetting. These patients had more embryos frozen, leading to more transfers and more successful pregnancies.
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Affiliation(s)
- Seifeldin Sadek
- Department of ObGyn, Eastern Virginia Medical School, The Jones Institute for Reproductive Medicine, 601 Colley Avenue, Norfolk, VA, 23507, USA.
| | - Hadi Ramadan
- Department of ObGyn, Eastern Virginia Medical School, The Jones Institute for Reproductive Medicine, 601 Colley Avenue, Norfolk, VA, 23507, USA
| | - Tamar Matitashvili
- Department of ObGyn, Eastern Virginia Medical School, The Jones Institute for Reproductive Medicine, 601 Colley Avenue, Norfolk, VA, 23507, USA
| | - Laurel Stadtmauer
- Department of ObGyn, Eastern Virginia Medical School, The Jones Institute for Reproductive Medicine, 601 Colley Avenue, Norfolk, VA, 23507, USA
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Atzmon Y, Michaeli M, Aslih N, Ruzov O, Rotfarb N, Shoshan-Karchovsky E, Shalom-Paz E. Degenerative Oocytes in the Aspirated Cohort Are Not Due to the Aspirating Needle: a Prospective Randomized Pilot Study with Sibling Oocytes. Reprod Sci 2020; 28:1882-1889. [PMID: 33171516 DOI: 10.1007/s43032-020-00384-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 11/01/2020] [Indexed: 11/25/2022]
Abstract
The aim of this study is to compare two different needles (17G vs. 20-17G variable diameter) used for OPU and to assess whether the different stress forces along the needle affect the presence of degenerative oocytes, oocyte quality, and embryo morphokinetics. Prospective, randomized study enrolled women undergoing in vitro fertilization (IVF) intracytoplasmic sperm injection (ICSI) from August 2016 through August 2018 in an IVF unit at a tertiary care medical center. Ovaries were randomly aspirated using either a 20-17G needle or a 17G needle. The embryologist was blinded to the aspirating needle and sibling oocytes were separated according to needle used for fertilization and further evaluation. Oocytes were scored negatively if one of the following parameters was abnormal immediately after OPU: polar body shape, zona pellucida, cytoplasm, perivitelline space, or vacuoles. The presence of degenerative oocytes was noted at OPU. A total of 580 oocytes from 43 women were evaluated, 293 in the 17G needle group and 287 in the 20-17G group. Oocyte scoring was comparable between the two different needles (- 1.99 ± 1.9 vs. - 1.88 ± 1.69; P = 0.13), as were embryo quality and pregnancy rate. Cohorts with degenerative oocytes had lower oocyte scores (- 2.11 ± 1.81 vs. - 1.60 ± 1.50; P = 0.001) and poorer performance and fertilization rates (62.5% vs. 78.5%; P < 0.001) than did cohorts with no degenerative oocytes. Cycles with degenerative oocytes in the cohort at OPU demonstrated poorer oocyte quality and decreased fertilization, regardless of the needle used. 1.5.2016 NIH number NCT02749773.
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Affiliation(s)
- Yuval Atzmon
- IVF Unit, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel, Ruth and Bruce Rappaport School of Medicine, Technion, Haifa, Israel.
| | - Mediea Michaeli
- IVF Unit, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel, Ruth and Bruce Rappaport School of Medicine, Technion, Haifa, Israel
| | - Nardin Aslih
- IVF Unit, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel, Ruth and Bruce Rappaport School of Medicine, Technion, Haifa, Israel
| | - Olga Ruzov
- IVF Unit, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel, Ruth and Bruce Rappaport School of Medicine, Technion, Haifa, Israel
| | - Nechami Rotfarb
- IVF Unit, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel, Ruth and Bruce Rappaport School of Medicine, Technion, Haifa, Israel
| | - Ester Shoshan-Karchovsky
- IVF Unit, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel, Ruth and Bruce Rappaport School of Medicine, Technion, Haifa, Israel
| | - Einat Shalom-Paz
- IVF Unit, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel, Ruth and Bruce Rappaport School of Medicine, Technion, Haifa, Israel
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