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      Recommendations for good practice in ultrasound: oocyte pick up

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          Abstract

          STUDY QUESTION

          What is good practice in ultrasound (US), and more specifically during the different stages of transvaginal oocyte retrieval, based on evidence in the literature and expert opinion on US practice in ART?

          SUMMARY ANSWER

          This document provides good practice recommendations covering technical aspects of US-guided transvaginal oocyte retrieval (oocyte pick up: OPU) formulated by a group of experts after considering the published data, and including the preparatory stage of OPU, the actual procedure and post-procedure care.

          WHAT IS KNOWN ALREADY

          US-guided transvaginal OPU is a widely performed procedure, but standards for best practice are not available.

          STUDY DESIGN, SIZE, DURATION

          A working group (WG) collaborated on writing recommendations on the practical aspects of transvaginal OPU. A literature search for evidence of the key aspects of the procedure was carried out. Selected papers ( n = 190) relevant to the topic were analyzed by the WG.

          PARTICIPANTS/MATERIALS, SETTING, METHODS

          The WG members considered the following key points in the papers: whether US practice standards were explained; to what extent the OPU technique was described and whether complications or incidents and how to prevent such events were reported. In the end, only 108 papers could be used to support the recommendations in this document, which focused on transvaginal OPU. Laparoscopic OPU, transabdominal OPU and OPU for IVM were outside the scope of the study.

          MAIN RESULTS AND THE ROLE OF CHANCE

          There was a scarcity of studies on the actual procedural OPU technique. The document presents general recommendations for transvaginal OPU, and specific recommendations for its different stages, including prior to, during and after the procedure. Most evidence focussed on comparing different equipment (needles) and on complications and risks, including the risk of infection. For these topics, the recommendations were largely based on the results of the studies. Recommendations are provided on equipment and materials, possible risks and complications, audit and training. One of the major research gaps was training and competence. This paper has also outlined a list of research priorities (including clarification on the value or full blood count, antibiotic prophylaxis and flushing, and the need for training and proficiency).

          LIMITATIONS, REASONS FOR CAUTION

          The recommendations of this paper were mostly based on clinical expertise, as at present, only a few clinical trials have focused on the oocyte retrieval techniques, and almost all available data are observational. In addition, studies focusing on OPU were heterogeneous with significant difference in techniques used, which made drafting conclusions and recommendations based on these studies even more challenging.

          WIDER IMPLICATIONS OF THE FINDINGS

          These recommendations complement previous guidelines on the management of good laboratory practice in ART. Some useful troubleshooting/checklist recommendations are given for easy implementation in clinical practice. These recommendations aim to contribute to the standardization of a rather common procedure that is still performed with great heterogeneity.

          STUDY FUNDING/COMPETING INTEREST(S)

          The meetings of the WG were funded by ESHRE. The other authors declare that they have no conflict of interest.

          TRIAL REGISTRATION NUMBER

          NA.

          ESHRE Pages content is not externally peer reviewed. The manuscript has been approved by the Executive Committee of ESHRE.

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            The Thessaloniki ESHRE/ESGE consensus on diagnosis of female genital anomalies

            What is the recommended diagnostic work-up of female genital anomalies according to the European Society of Human Reproduction and Embryology (ESHRE)/European Society for Gynaecological Endoscopy (ESGE) system?
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                Author and article information

                Journal
                Hum Reprod Open
                Hum Reprod Open
                hropen
                Human Reproduction Open
                Oxford University Press
                2399-3529
                2019
                10 December 2019
                10 December 2019
                : 2019
                : 4
                : hoz025
                Affiliations
                [1 ] Wales Fertility Institute , University Hospital of Wales, Cardiff University, Cardiff, UK
                [2 ] Bourn Hall IVF Center , Wickford, Essex, UK
                [3 ] Cardiff University , Cardiff, South Glamorgan, UK
                [4 ] Department of Morphology Surgery and Experimental Medicine , University of Ferrara, Ferrara, Emilia-Romagna, Italy
                [5 ] Instituto Valenciano de Infertilidad , IVI Bilbao, Bilbao, Spain; Human Reproduction Unit, Cruces University Hospital, Bilbao, Spain; Department of Obstetrics and Gynecology, Basque Country University, Spain; BioCruces Research Center Bilbao, Bilbao, Spain
                [6 ] Department of Obstetrics and Gynecology , University of Medicine and Pharmacy “Gr.T.Popa”, Iasie, Romania
                [7 ] Department of Obstetrics and Gynecology , IVF Unit, Harran University, Sanliurfa 63300, Turkey
                [8 ] Department for Reproductive Medicine , University hospital, Ghent, Belgium
                [9 ] Department of Obstetrics and Gynecology , University of Helsinki, Helsinki, Finland
                [10 ] ESHRE Central Office , Grimbergen, Belgium
                [11 ] IVF Adria Consulting , Maribor, Slovenia
                Author notes
                Correspondence address. Wales Fertility Institute, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, UK. E-mail: DAngeloA@ 123456cardiff.ac.uk , guidelines@ 123456eshre.eu

                ESHRE pages content is not externally peer reviewed. The manuscript has been approved by the Executive Committee of ESHRE.

                Arianna D’Angelo and Costas Panayotidis are both to be marked as joint second author.

                Author information
                http://orcid.org/0000-0002-1505-8489
                http://orcid.org/0000-0001-8046-6799
                Article
                hoz025
                10.1093/hropen/hoz025
                6903452
                31844683
                b05321c5-351c-4110-adce-7bbaf7dc14eb
                © The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

                History
                : 22 June 2019
                : 22 June 2019
                : 29 July 2019
                : 29 July 2019
                Page count
                Pages: 25
                Funding
                Funded by: European Society of Human Reproduction and Embryology to WG
                Categories
                ESHRE Pages

                good practice,recommendations,ultrasound,oocyte retrieval,oocyte pick up,art,guideline,needle,competence,quality

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