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7 - Techniques for IVF

Published online by Cambridge University Press:  22 October 2009

Tim J. Child
Affiliation:
Women's Centre, John Radcliffe Hospital, Oxford, UK
Imran R. Pirwany
Affiliation:
McGill Reproductive Centre, Royal Victoria Hospital, Montreal, Quebec, Canada
Seang Lin Tan
Affiliation:
McGill Reproductive Centre, Royal Victoria Hospital, Montreal, Quebec, Canada
Paul Serhal
Affiliation:
The University College London Hospitals
Caroline Overton
Affiliation:
Bristol Royal Infirmary
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Summary

Much recent research in IVF treatment has concentrated on ovarian stimulation drugs, regimens, improving the laboratory techniques of oocyte fertilization and embryo culture. However, efficient and effective oocyte recovery and embryo transfer techniques may have been neglected. This is unfortunate, as efforts to maximize ovarian stimulation and the work of embryologists in producing high quality embryos and blastocysts may be squandered if suboptimal oocyte retrieval and embryo transfer techniques are used. In this chapter we describe an evidence-based approach to oocyte retrieval and embryo transfer and briefly review the ongoing debate on the number of embryos transferred.

Oocyte retrieval

The early years of IVF were characterized by laparoscopic oocyte retrieval from unstimulated ovaries during the natural menstrual cycle. The disadvantages of laparoscopic oocyte retrieval include the need for general anaesthesia, the small but finite risk of damage to abdominal organs and blood vessels, and the greater overall cost and inconvenience to the patient of an IVF treatment cycle. Since most women will require repeated IVF treatment cycles, laparoscopy is not satisfactory as a routine method of oocyte retrieval.

By the early 1980s ultrasound technology had developed to such an extent that the first cases of transvesical oocyte recovery under transabdominal ultrasound guidance were reported (Lenz et al., 1981). This was a major advance over the laparoscopic approach. By the late 1980s the development of high frequency vaginal probe ultrasound transducers allowed direct transvaginal ultrasound directed oocyte retrieval (TUDOR). A number of randomized trials testify to the advantages of this method over alternative approaches and TUDOR remains the method of choice (Tan et al., 1990).

Recently, follicular aspiration under three-dimensional ultrasound control has been reported (Feichtinger, 1998).

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Publisher: Cambridge University Press
Print publication year: 2004

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  • Techniques for IVF
    • By Tim J. Child, Women's Centre, John Radcliffe Hospital, Oxford, UK, Imran R. Pirwany, McGill Reproductive Centre, Royal Victoria Hospital, Montreal, Quebec, Canada, Seang Lin Tan, McGill Reproductive Centre, Royal Victoria Hospital, Montreal, Quebec, Canada
  • Edited by Paul Serhal, Caroline Overton
  • Book: Good Clinical Practice in Assisted Reproduction
  • Online publication: 22 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511550768.009
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  • Techniques for IVF
    • By Tim J. Child, Women's Centre, John Radcliffe Hospital, Oxford, UK, Imran R. Pirwany, McGill Reproductive Centre, Royal Victoria Hospital, Montreal, Quebec, Canada, Seang Lin Tan, McGill Reproductive Centre, Royal Victoria Hospital, Montreal, Quebec, Canada
  • Edited by Paul Serhal, Caroline Overton
  • Book: Good Clinical Practice in Assisted Reproduction
  • Online publication: 22 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511550768.009
Available formats
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Send book to Google Drive

To send content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Google Drive.

  • Techniques for IVF
    • By Tim J. Child, Women's Centre, John Radcliffe Hospital, Oxford, UK, Imran R. Pirwany, McGill Reproductive Centre, Royal Victoria Hospital, Montreal, Quebec, Canada, Seang Lin Tan, McGill Reproductive Centre, Royal Victoria Hospital, Montreal, Quebec, Canada
  • Edited by Paul Serhal, Caroline Overton
  • Book: Good Clinical Practice in Assisted Reproduction
  • Online publication: 22 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511550768.009
Available formats
×