Transmyometrial oocyte retrieval and pregnancy rates.

OBJECTIVE

To determine whether transvaginal, ultrasound-guided oocyte retrieval performed through the myometrium has a negative impact on IVF pregnancy rates.

DESIGN

Retrospective cohort study.

SETTING

Academic hospital and research center.

PATIENT(S): A total of 5,115 IVF cycles performed at the Brigham and Women's Hospital between 1998 and 2001 were evaluated. In 85 cycles (1.7%), the oocyte retrieval needle passed through the myometrium because of ovarian position during retrieval. Each of these cases was matched to a control cycle by age, attempt number, and date of retrieval.

INTERVENTION(S): Transmyometrial oocyte retrieval.

MAIN OUTCOME MEASURE(S): Pregnancy rates.

RESULT(S): There were no statistically significant differences in pregnancy rates between cases and controls. Cases were more likely than controls to have underlying tubal disease and adhesions as the primary cause of infertility. The groups did not differ significantly in terms of age, attempt number, estradiol level, follicle number, days stimulated, ampules of gonadotropins administered, number of eggs, number of embryos, or quality of embryos.

CONCLUSION(S): Transmyometrial oocyte retrieval is an uncommon event. Clinicians and patients can be reassured that transmyometrial oocyte retrieval does not seem to decrease IVF pregnancy rates; however, a larger study with greater power might reveal a statistically significant difference.