Evidence-based Oocyte Aspiration and Embryo Transfer

Abstract

When the first successful delivery following in vitro fertilization and embryo transfer was reported in 1978, oocyte aspiration was performed laparoscopically under general anesthesia. Since 1985, almost all IVF centers have collected oocytes using transvaginal ultrasound-directed methods, since these are the easiest, most accurate and most acceptable methods to patients. Color Doppler ultrasonography is recommended to decrease blood loss during oocyte aspiration. Embryos are gently, slowly and transcervically expelled into the uterine cavity, with the patient in a lithotomy position. This basic method has remained unchanged since the first descriptions. Relatively important factors for successful embryo transfer include removal of hydrosalpinges, absence of blood or mucus on catheter, catheter type, avoidance of fundus contact, avoiding tenaculum, removal of all mucus, ultrasonography of cavity before puncture, leaving the catheter in place for 1 min, 30-min bed rest, trial transfer, ultrasonographic monitoring and antiprostaglandin administration to prevent uterine contractions.