Does Oocyte Retrieval Performance in Mono-follicular Cycles Differ by Physician Experience?

Oocyte pick-up (OPU) is considered as a minor surgical procedure and complications are very rare when performed by trained physicians. However, data on training standards are limited and assessment of proficiency is challenging. The aim of this study was to show the impact of physician experience on OPU performance in mono-follicular in vitro fertilization (IVF) cycles, using two measurable outcome parameters: successful oocyte retrieval and operative time. Senior physicians (n = 6) had over 15 years of experience and novice physicians (n = 4) had at least 30 procedures under supervision. The study population included 226 mono-follicular cycles. Oocyte retrieval was successful in 179 out 226 procedures (79.2%); seniors and novices achieved similar oocyte retrieval rates (74.1%, 43/58 vs 80.9%, 136/168, p = 0.270). The mean duration of the procedure was 513.4 ± 163.1 (126-769) s. It was significantly shorter with a mean difference of - 117.9 s (95% CI: - 164.4 to - 71.3, p = 0.0001, Hedges g = 1.3) for senior physicians when compared to novices (425.8 ± 146.2 versus 543.7 ± 157.9 s). Novices who start performing OPU independently after 30 supervised procedures perform well in collecting the single oocyte grown in mono-follicular cycles; however, the mean duration of the procedure is relatively longer compared to seniors. After initial training period, physicians have few opportunities to compare themselves with their seniors and peers; periodical reassessment of the technique-which should also cover managing the operation time-would help confirm their own practices.

Perceived stress and sleep quality before oocyte pick-up, embryo transfer, and pregnancy test in women receiving in vitro fertilization treatment

BACKGROUND

Infertility is a major health problem that affects both the family and the community. Women receiving infertility treatment may suffer from stress and even experience sleep disturbance. Sleep quality is an important factor of human health and well-being. Sleep disturbances tend to occur among infertile women during in vitro fertilization treatment. Many studies have focused on the stress and sleep quality associated with their treatment in infertile women. However, few studies have investigated factors linked to their sleep disturbances.

OBJECTIVE

This study investigated the relationship between perceived stress and sleep quality before oocyte pick-up, in vitro fertilization-embryo transfer, and pregnancy test in women receiving in vitro fertilization treatment.

MATERIAL AND METHODS

This prospective, longitudinal study was conducted between January and May 2020. One hundred fifty-seven women receiving infertility treatment were included in the study. A personal information form, the Perceived Stress Scale (PSS), and the Pittsburgh Sleep Quality Index (PSQI) were used to collect data.

RESULTS

The relationship between the Perceived Stress Scale scores and the Pittsburgh Sleep Quality Index scores in all stages of infertility treatment was found to be positively significant at the p < .001 significance level.

CONCLUSION

Perceived stress level was high in women throughout the infertility treatment. Our study suggested that sleep quality was impaired as stress increased.

TRIAL REGISTRATION

70904504/38.

A Pilot Study on Oocyte Retrieval Simulator: A New Tool for Training?

This prospective study was aimed at assessing the usefulness of a box simulator in oocyte pick-up and at establishing whether it could be an appropriate training tool for egg retrieval. Forty-four clinicians, divided in two groups on the grounds of the previous experience (Novices and Experts), participated to two training sessions with a pick-up simulator. Data concerning the mean number of follicles correctly aspired (%OK med), the average time needed to correctly aspirate one follicle (t foll med) and the ratio between the two afore-mentioned parameters (%OK med/t foll med) were collected. At the end of the two sessions all participants completed a questionnaire aimed at assessing the performance of the simulator in terms of realism and acceptability for use. A significant improvement in efficiency (mean number of follicles correctly aspired, 82% versus 75%), speed (mean time needed to aspirate one follicle, 21 versus 28 s) and accuracy (mean percentage of follicles correctly aspirated in one minute, 2.53% versus 1.86%) was noted in the total sample. The performance accuracy was significantly increased in both groups (2.34% versus 1.83% for Novices and 2.50% versus 2.06%, for Experts). Speed was significantly improved in the Novices' group. Simulator-based training has been shown to be effective and useful and it should be considered in training programs.

Efficacy of bispectral index monitoring for prevention of anestheticawareness and complications during oocyte pick-up procedure

Background/aim: This study was planned by considering that the use of bispectral index (BIS) monitoring ensures sufficient depth of anesthesia and avoids anesthetic awareness and patient movement in the oocyte pick-up (OPU) procedure.Materials and methods: Ninety-eight patients undergoing OPU were randomly divided into 2 groups as the control group (n = 48) and BIS group (n = 50). After propofol and remifentanil induction, the control group was given additional propofol according to reaction response, while the BIS group was given propofol at BIS values of 60 and above with the aim that BIS values be 40?60. Total procedure time, recovery time, patient movement, additional propofol consumption, total number of oocytes, and awareness during anesthesia were recorded. Results: Demographic data were similar in the two groups (P > 0.05 for all). The recovery time in the BIS group was significantly shorter compared to the control group (P < 0.001) while additional propofol consumption was found to be significantly lower (P < 0.001). Baseline BIS values fell compared to all other times after induction significantly (P < 0.001). No patient had anesthesia awareness.Conclusion: During the OPU procedure BIS monitoring is considered to prevent anesthesia awareness, intraoperative movement, and complications caused by insufficient anesthetic use as it ensures optimal doses of anesthetic agents used and early recovery.