Effect of transuterine puncture during transvaginal oocyte retrieval on the results of human in-vitro fertilization.

In many in-vitro fertilization (IVF) programmes, the transvaginal approach is now the most widely used method for ultrasound-guided oocyte retrieval. Sometimes, however, the position of the ovaries is such that it might not be possible to aspirate the follicle transvaginally without puncturing the uterine wall. Between May and November 1988, we performed 518 transvaginal, ultrasound-guided oocyte retrievals for IVF or zygote intra-Fallopian transfer (ZIFT). During this period, 22 transuterine punctures (4.2%) were necessary to reach one of the ovaries. To investigate the effect of uterine laceration on the results of IVF/ZIFT treatment, the outcome of treatment was compared between patients who had a transuterine puncture and a control group of patients treated by IVF or ZIFT during the same period without transuterine puncture. Seven of 16 patients who had a transuterine puncture became pregnant after IVF, compared to 84 pregnancies out of 347 cases (24.2%) in the control group. After ZIFT, two pregnancies (2/6) were achieved in patients with uterine laceration, compared to 46 pregnancies out of 149 procedures (30.8%) in the control group. These differences were not statistically significant. Transuterine puncture during transvaginal oocyte retrieval does not seem to have an adverse effect on the results of human IVF and ZIFT treatment.