ISSN: 2148-8274 / E-ISSN: 2587-0084
, Türk Üreme Tıbbı ve Cerrahisi
Dergisi

Turkish Journal of Reproductive Medicine and Surgery

Dernek Sitesi
Kayıtlı İndexler
ORİJİNAL ARAŞTIRMALAR

Oosit Kriyoprezervasyon Amacı IVF Yapılan Endometriomali Bekar Kadınlarda Vajinal Ultrason Probu ile Transabdominal Oosit Toplanmasının Etkinliği ve Güvenliği
The Effectiveness and Safety of Transabdominal Oocyte Pick up Using a Vaginal Ultrasound Probe in Patients with Endometrioma Undergoing Oocyte Cryopreservation
Received Date : 15 Aug 2023
Accepted Date : 22 Aug 2023
Available Online : 01 Sep 2023
Doi: 10.24074/tjrms.2023-99093 - Makale Dili: EN
TJRMS. 2023;7(3):89-93
ÖZET
Amaç: Endometrioması olan bekar kadınlarda oosit kriyoprezervasyon amacı ile yapılan IVF’te transabdominal oosit toplanmasının etkinliği ve güvenliğini araştırmak. Gereç ve Yöntemler: Bu retrospektif kohort çalışmada endometrioması olan 13 bekar hastada oosit kriyoprezervasyonu amacı ile transabdominal oosit toplanmasının etkinliği ve güvenliği araştırılmıştır. Hastaların demografik özellikleri, serum AMH değeri, 3. gün serum FSH, LH, estradiol ve progesteron değerleri ile antral folikül sayıları kayıt edilmiştir. Çalışmanın ana amacı olarak toplanan oosit sayısı, metafaz 2 oosit sayısı, folikül-oosit indeksi ve komplikasyon oranları belirlenirken, ikincil amaç olarak ise stimülasyon süresi, toplam kullanılan gonadotropin miktarı ve işlem süresi olarak belirlenmiştir. Bulgular: Çalışamaya dahil edilen hastaların ortalama yaşı 32,78,5 olarak hesaplandı. Ortalama endometrioma boyutu 48,123,6 mm, ortalama serum AMH düzeyi 0.620.32 ng/ml, 3. gün serum FSH düzeyi 9,32,4 IU/ml, serum estradiol düzeyi 60,028,6 pg/ml ve ortalama antral folikül sayısı 6,022,92 olarak hesaplandı. Ortalama değerler olarak; simülasyon süresi 8,51,98, toplam kullanılan gonadotropin miktarı 1659546 ünite, ortalama işlem süresi 8.33.9 dk., toplanan oosit sayısı 5,53.1 ve dondurulan olgun oosit sayısı 4,152.23 olarak saptandı. Ortalama folikül oosit indeksi ise 0,930,17 olarak hesaplandı. Hastaların hiçbirinde majör bir komplikasyon oluşmadı, sadece bir hastada 6 saatlik hastane yatışı gerektiren şiddetli pelvik ağrı oluştu. Sonuç: Endometrioma nedeni ile oosit kriyoprezervasyonu yapılan bekar hastalarda transabdominal oosit toplanması etkin ve güvenilir bir yöntemdir.
ABSTRACT
Objective: To assess whether transabdominal oocyte pick up is safe and effective in single patients with endometrioma undergoing IVF for the purpose of oocyte cryopreservation. Materials and Methods: In this retrospective cohort study 13 virgin patients with endometrioma who underwent transabdominal oocyte pick-up for the purpose of oocyte cryopreservation was analyzed. Demographic characteristics, and hormonal assessment including AMH, day 3 serum FSH, LH, estradiol and progesterone levels, and antral follicle counts were recorded. Primary outcome measures were number of oocytes retrieved, metaphase 2 oocytes frozen, follicle oocyte index, and complication rates, while secondary outcome measures were duration of stimulation, cumulative gonadotropin dose, and duration of the procedure. Results: The mean age of patients was 32,78,5. The mean diameter of the endometrioma was 48,123,6 mm, antral follicle count was 6,022,92, serum AMH was 0.620.32 ng/ml, and day 3 serum FSH and estradiol were 9,32,4 IU/ml and 60,028,6 pg/ml respectively. The mean duration of stimulation was 8,51,98 days, cumulative gonadotropin consumption was 1659546 units, and duration of the procedure was 8.33.9 min. The mean number of oocytes retrieved was 5,53.1, oocytes frozen was 4,152.23, and mean modified follicle oocyte index was 0,930,17. No major complication occurred in any of the patients; however, one patient was temporarily hospitalized for six hours for severe pelvic pain. Conclusions: Transabdominal oocyte pick up is safe and effective procedure in single patients with endometrioma undergoing IVF for the purpose of oocyte cryopreservation.
REFERANSLAR
  1. Fishel S. First in vitro fertilization baby-this is how it happened. Fertil Steril. 2018 1;110:5-11 [Crossref]  [PubMed] 
  2. Lenz S, Lauritsen JG, Kjellow M. Collection of human oocytes for in vitro fertilisation by ultrasonically guided follicular puncture . Lancet. 1981;1(8230): 1163-4. [Crossref]  [PubMed] 
  3. Steigrad S, Hacker NF, Kolb B. In vitro fertilization surrogate pregnancy in a patient who underwent radical hysterectomy followed by ovarian transposition, lower abdominal wall radiotherapy, and chemotherapy. Fertil Steril. 2005;83(5):1547-9. [Crossref]  [PubMed] 
  4. Azem F, Yovel I, Wagman I, Kapostiansky R, Lessing JB, Amit A. Surrogate pregnancy in a patient who underwent radical hysterectomy and bilateral transposition of ovaries. Fertil Steril. 2003;79(5):1229-30. [Crossref]  [PubMed] 
  5. Oktay K, Economos K, Kan M, Rucinski J, Veeck L, Rosenwaks Z. Endocrine function and oocyte retrieval after autologous transplantation of ovarian cortical strips to the forearm. JAMA. 2001;286(12):1490-3. [Crossref]  [PubMed] 
  6. Stern CJ, Gook D, Hale LG, Agresta F, Oldham J, Rozen G, Jobling T. First reported clinical pregnancy following heterotopic grafting of cryopreserved ovarian tissue in a woman after a bilateral oophorectomy. Hum Reprod. 2013;28(11):2996-9. [Crossref]  [PubMed] 
  7. Baldini D, Lavopa C, Vizziello G, Sciancalepore A, Malvasi A. The safe use of the transvaginal ultrasound probe for transabdominal oocyte retrieval in patients with vaginally inaccessible ovaries. Front Women Health. 2018;3(2):1-3. [Crossref] 
  8. Sönmezer M, Gülümser Ç, Sönmezer M, Sükür YE, Atabekoğlu C. Transabdominal ultrasound guided oocyte retrieval using vaginal ultrasound probe: Definition of the technique. Obstet Gynaecol Res. 2021;47(2):800-6. [Crossref]  [PubMed] 
  9. Sönmezer M, Saçıntı KG, Gülümser Ç, Özkavukçu S, Atabekoğlu C, Şükür YE, Sönmezer M. Transabdominal ultrasound-guided oocyte retrieval for oocyte cryopreservation using a vaginal probe: a comparison of applicability, effectiveness, and safety with conventional transvaginal approach. J Assist Reprod Genet. 2023;40(2):399-405. [Crossref]  [PubMed] 
  10. Seval MM, Özmen B, Atabekoğlu C, Şükür YE, Şimşir C, Kan Ö, Sönmezer M. Dual trigger with gonadotropin-releasing hormone agonist and recombinant human chorionic gonadotropin improves in vitro fertilization outcome in gonadotropin-releasing hormone antagonist cycles. J Obstet Gynaecol Res. 2016;42(9):1146-51. [Crossref]  [PubMed] 
  11. Latif S, Saridogan E. Endometriosis, Oocyte, and Embryo Quality. J Clin Med. 2023;12(13):4186. [Crossref]  [PubMed]  [PMC] 
  12. Benaglia L, Somigliana E, Iemmello R, Colpi E, Nicolosi AE, Ragni G. Endometrioma and oocyte retrieval-induced pelvic abscess: a clinical concern or an exceptional complication? Fertil Steril. 2008;89(5):1263-6. [Crossref]  [PubMed] 
  13. Villette C, Bourret A, Santulli P, Gayet V, Chapron C, de Ziegler D. Risks of tubo-ovarian abscess in cases of endometrioma and assisted reproductive technologies are both under- and overreported. Fertil Steril. 2016;106(2):410-5. [Crossref]  [PubMed] 
  14. Miller KD, Nogueira L, Mariotto AB, Rowland JH, Yabroff KR, Alfano CM, Jemal A, Kramer JL, Siegel RL. Cancer treatment and survivorship statistics, 2019. CA Cancer J Clin. 2019;69(5):363-85. [Crossref]  [PubMed]