Transmyometrial oocyte recruitment: a safe surgical procedure alternative to the transvaginal retrieval when ovaries are inaccessible

Abstract

Background: This study aims to investigate the intra-cytoplasmic semen injection (ICSI) outcomes and the potential complications of transmyometrial oocyte retrieval performed in patients with one or both inaccessible ovaries.Methods: From January 2004 to December 2018 were evaluated 11,273 oocytes retrievals, of which 594 not conventional procedures for inaccessible ovaries through transvaginal retrieval. Despite alternative approaches tested by clinicians during the oocyte pick up (OPU), in 113 of these patients (Group A) were indispensable the needle’s passage through the myometrium, compared to as many controls (Group B) from the 481 remaining women without this necessity. The two resulting groups were matched for their reproductive outcomes and the relative developed complications.Results: No statistically significant differences were found between the two Groups in terms of number of eggs/embryos obtained, ongoing pregnancy rate and spontaneous miscarriage. A complete absence of complications as peritoneal and endometrial bleeding after 4 and 24 hours from the transmyometrial access was reported for the whole cohort.Conclusions: This study shows that the transvaginal transmyometrial oocyte retrieval does not affect the OPU outcome even if the passage of the needle occurs through the endometrium, not inducing significant complications. Thus, here we support both efficacy and safety of transmyometrial follicular aspiration as a valid surgical approach in conditions of inaccessible ovaries.