Combined transvaginal and transabdominal oocyte retrieval in a patient with an ectopic ovary and unicornuate uterus

Combined transvaginal and transabdominal oocyte retrieval are safe and feasible in patients with an ectopic ovary located in the upper abdomen.

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VOLUME 115, ISSUE 5, P1347-1349

Authors:

Nigel Pereira, M.D., Stephanie Willson, M.D., Kelly McCarter, M.D., Pak H. Chung, M.D., Isaac Kligman, M.D., Zev Rosenwaks, M.D.

Abstract:

Objective

To report the utility of combined transvaginal and transabdominal oocyte retrieval in a patient with an ectopic ovary and unicornuate uterus.


Design

Video case report with demonstration of oocyte retrieval technique.


Setting(s)

University-affiliated fertility center.


Patient(s)

A 35-year-old woman, gravida 0, with a 6-month history of infertility who presented to our center for fertility evaluation. Hysterosalpingography revealed a left unicornuate uterus and patent left fallopian tube magnetic resonance imaging and laparoscopy showed a right ectopic ovary located in the upper abdomen. Her partner was a 36-year-old male with isolated teratozoospermia. The couple did not conceive with intrauterine insemination.


Intervention(s)

Ovarian stimulation for in vitro fertilization (IVF). Transvaginal retrieval of oocytes from the right ovary was not deemed possible due the anatomic location of the ovary, intervening blood vessels, and limited mobility of the ovary. Institutional review board approval was not required for this case report as per our institution’s policy; patient consent was obtained for publication of the case.


Main Outcome Measure(s)

Transabdominal retrieval of oocytes from the right ovary and transvaginal retrieval of oocytes from the left ovary.


Result(s)

The couple underwent two IVF cycles. Nine oocytes were retrieved during the first IVF cycle: seven transabdominal (right ovary) and two transvaginal (left ovary). All oocytes were mature, and five blastocysts were cryopreserved. Eight oocytes were retrieved during the second IVF cycle, of which five oocytes were retrieved transabdominally from the right ovary, and three oocytes were retrieved transvaginally from the left ovary. All oocytes were mature, and four blastocysts were cryopreserved. A single thawed embryo was transferred in the natural menstrual cycle, which resulted in the live birth of a full-term baby boy weighing 2,410 grams.


Conclusion(s)

The current case highlights the safety and feasibility of combined transvaginal and transabdominal oocyte retrieval in patients with an ectopic ovary located in the upper abdomen.

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. 

Comments

Go to the profile of Erika P. New
7 months ago

Thank you for an excellent, very educational video! When taking care of any patient with ovaries that are difficult to reach vaginally (large fibroid uterus, prior ovarian transposition, etc), it is important to be able to perform transabdominal oocyte retrieval when indicated. Since this is performed infrequently, I appreciate you sharing your video to help other providers learn more about this technique.