Aydin Arici's Current Opinion in Obstetrics & Gynecology JUNE 2010 PDF

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7). Transfer of higher estimated embryo implantation potentials was associated with a decreased ectopic risk when two or fewer embryos were transferred, but not when three or more embryos were transferred. And these similar protective effects also could be observed among donor oocyte procedure, further supporting the hypothesis that embryo implantation potential is associated with risk of ectopic pregnancy. Conclusion The potential interfering factor in interaction of tubal function and transferred embryo is different hormonal milieu at the time of embryo transfer from hyperstimulation protocols.

Laparoscopy was soon replaced by transvaginal retrieval under ultrasound guidance as the primary route to obtain oocytes for assisted reproductive technologies (ART) due to its safety, effectiveness, and the avoidance of general anesthesia [3–6]. The conversion to a transvaginal retrieval approach was followed by refinements in the oocyte retrieval needle design in an effort to maximize recovery and minimize patient discomfort [7–9]. Double-lumen needles (one channel to withdraw follicular fluid and another to instill isotonic saline into the follicle) were developed to allow for simultaneous or intermittent flushing and aspiration of ovarian follicles, a process that could not be accomplished with single-lumen retrieval needles [10].

Such an experimental design makes definitive conclusions difficult and highlights the need for randomized controlled trials. However, these data suggest a potential for benefit with follicular flushing in patients undergoing seminatural or minimal stimulation ART. of four patients showed 100% oocyte recovery in three patients and 71% oocyte retrieval in the fourth patient. The authors argued that follicular flushing might help to maximize oocyte yield in IVM cycles, though it is difficult to draw definitive conclusions from such small numbers.

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Current Opinion in Obstetrics & Gynecology JUNE 2010 by Aydin Arici

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