Degenerative Oocytes in the Aspirated Cohort Are Not Due to the Aspirating Needle: a Prospective Randomized Pilot Study
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REPRODUCTIVE ENDOCRINOLOGY: ORIGINAL ARTICLE
Degenerative Oocytes in the Aspirated Cohort Are Not Due to the Aspirating Needle: a Prospective Randomized Pilot Study with Sibling Oocytes Yuval Atzmon 1 & Mediea Michaeli 1 & Nardin Aslih 1 & Olga Ruzov 1 & Nechami Rotfarb 1 & Ester Shoshan-Karchovsky 1 & Einat Shalom-Paz 1 Received: 22 May 2020 / Accepted: 1 November 2020 # Society for Reproductive Investigation 2020
Abstract The aim of this study is to compare two different needles (17G vs. 20-17G variable diameter) used for OPU and to assess whether the different stress forces along the needle affect the presence of degenerative oocytes, oocyte quality, and embryo morphokinetics. Prospective, randomized study enrolled women undergoing in vitro fertilization (IVF) intracytoplasmic sperm injection (ICSI) from August 2016 through August 2018 in an IVF unit at a tertiary care medical center. Ovaries were randomly aspirated using either a 20-17G needle or a 17G needle. The embryologist was blinded to the aspirating needle and sibling oocytes were separated according to needle used for fertilization and further evaluation. Oocytes were scored negatively if one of the following parameters was abnormal immediately after OPU: polar body shape, zona pellucida, cytoplasm, perivitelline space, or vacuoles. The presence of degenerative oocytes was noted at OPU. A total of 580 oocytes from 43 women were evaluated, 293 in the 17G needle group and 287 in the 20-17G group. Oocyte scoring was comparable between the two different needles (− 1.99 ± 1.9 vs. − 1.88 ± 1.69; P = 0.13), as were embryo quality and pregnancy rate. Cohorts with degenerative oocytes had lower oocyte scores (− 2.11 ± 1.81 vs. − 1.60 ± 1.50; P = 0.001) and poorer performance and fertilization rates (62.5% vs. 78.5%; P < 0.001) than did cohorts with no degenerative oocytes. Cycles with degenerative oocytes in the cohort at OPU demonstrated poorer oocyte quality and decreased fertilization, regardless of the needle used. 1.5.2016 NIH number NCT02749773 Keywords Ovum pick-up . Needle . Oocyte quality . Embryo morphokinetics
Introduction In the art of ART, oocyte pick-up (OPU) techniques and methods are well-established. Various needle sizes are available for OPU in vitro fertilization (IVF), ranging from 16 gauge (G) to 20G, with double or single lumens. Manufacturer recommendations include different negative pressures based on needle diameter. Several studies showed that smaller diameter needles result in significant improvement in recovery after OPU, minimize bleeding during the procedure, and reduce pain afterwards [1–3]. However, no
* Yuval Atzmon [email protected] 1
IVF Unit, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel, Ruth and Bruce Rappaport School of Medicine, Technion, Haifa, Israel
study has evaluated the impact of needle diameter on oocyte integrity, presence of degenerative oocytes (DEG), and the outcome of the fertilized oocytes. With the aim of creating a needle that reduces pain without diminishing its
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