Manual of oocyte retrieval and preparation in human assisted reproduction / edited by Rachel Cutting, Mostafa Metwally.

Format:

Book

Contributor:

Cutting, Rachel, editor.

Metwally, Mostafa, editor.

Series:

Cambridge medicine (Series)

Cambridge medicine

Language:

English

Subjects (All):

Human reproductive technology.

Fertilization in vitro, Human.

Ovum.

Physical Description:

1 online resource (vi, 119 pages) : digital, PDF file(s).

Edition:

First edition.

Place of Publication:

Cambridge ; New York, NY : Cambridge University Press, 2023.

Summary:

Obtaining good quality oocytes and preparing them for in-vitro fertilization (IVF) is a key stage in assisted reproduction. This is a complex process with many pitfalls, making good clinical preparation and laboratory technique essential for success. Illustrated throughout, this book will be valuable to clinical embryologists, laboratory personnel wishing to redefine or develop technique and improve outcomes, IVF quality managers, and gynecologists performing oocyte retrieval. Featuring descriptions of the underlying science along with practical advice on methods and trouble-shooting, this comprehensive manual will aid all those involved in this complex process of oocyte retrieval and preparation in navigating towards optimal outcomes.

Contents:

Cover

Half-title

Title page

Copyright information

Contents

List of Contributors

Chapter 1 The Ovary: A General Overview of Follicle Formation and Development

1.1 Introduction

1.2 Sex Determination and Early Gonadal Development

1.3 Follicle Formation: Establishment of the Ovarian Reserve

1.4 Follicle Development

1.4.1 Primordial Follicles

1.4.2 Preantral Follicles

1.4.3 Antral Follicles

1.4.3.1 Morphological Changes

1.4.3.2 Steroidogenesis and Atresia

1.4.3.3 Oocyte Development

1.4.4 The Ovulatory Follicle

1.4.4.1 Cumulus Expansion

1.4.4.2 Resumption of Meiosis

1.4.4.3 Ovulation

1.5 Corpus Luteum

1.6 Summary

Acknowledgements

References

Chapter 2 Monitoring of Ovarian Stimulation

2.1 Introduction

2.2 Criteria to Trigger

2.3 Timing between Trigger and Oocyte Retrieval

2.4 Type of Trigger Injection

2.5 Pre-operative Assessment for Oocyte Retrieval

2.6 Consent

2.7 Summary

Chapter 3 Theatre Design, Equipment and Consumables for Oocyte Retrieval

3.1 Introduction

3.2 Design Considerations

3.3 Anaesthetic Room

3.4 Procedure Room

3.5 Air Quality

3.6 Equipment

3.7 Summary

Chapter 4 Conscious Sedation and Analgesia for Oocyte Retrieval

4.1 Introduction

4.2 Pre-operative Assessment

4.3 Fasting Guidelines

4.4 Sedation and Analgesia Medication for Oocyte Retrieval

4.4.1 Midazolam

4.4.2 Propofol

4.4.3 Alfentanil

4.4.4 Diclofenac

4.5 Ovarian Hyperstimulation Syndrome

4.6 Monitoring and Oxygenation

4.7 Post-sedation Care

4.8 Nurse-Led Conscious Sedation

4.8.1 Sedation Protocols

4.8.2 Training

4.8.3 Clinical Service Evaluation

4.8.4 Challenges

4.9 Summary

Chapter 5 Practical Clinical Aspects of Oocyte Retrieval

5.1 Introduction.

5.2 Considerations before Oocyte Retrieval

5.2.1 Scheduling

5.2.2 Preparation

5.2.3 Know Your Patient

5.2.4 The Patient's Perspective

5.3 Considerations for the Theatre Routine

5.3.1 In Theatre

5.3.2 Sterility

5.3.3 Patient Positioning

5.3.4 Vaginal Preparation

5.3.5 Antibiotic Prophylaxis

5.4 Equipment Required for Oocyte Retrieval

5.4.1 Ultrasound Scan Machine

5.4.2 Temperature Control

5.4.3 Aspiration Needles

5.4.4 To Flush or Not To Flush?

5.4.5 Flushing the Tubing System

5.5 The Technique of Oocyte Retrieval

5.5.1 Description of the Procedure

5.5.2 Oocyte Retrieval for In Vitro Maturation

5.5.3 Technique of Follicular Flushing

5.6 Common Difficulties during Oocyte Retrieval

5.6.1 Endometrioma and Other Cysts

5.6.2 Difficulty in Accessing the Ovaries

5.6.3 Bleeding during Oocyte Retrieval

5.7 After the Procedure

Chapter 6 Challenges during Oocyte Retrieval

6.1 Difficult Ovarian Access

6.1.1 Management

6.1.1.1 Emptying the Bladder

6.1.1.2 Position of the Probe

6.1.1.3 Use of a Tenaculum

6.1.1.4 Transmyometrial Access of the Ovaries

6.1.1.5 Transabdominal Ultrasound-Guided or Laparoscopic Oocyte Retrieval

Transabdominal Ultrasound-Guided Oocyte Retrieval

Laparoscopic Oocyte Retrieval

6.2 Bleeding Complications

6.2.1 Minor Local Vaginal Bleeding

6.2.2 Intra-Abdominal Bleeding

6.3 Empty Follicle Syndrome

6.3.1 Management

6.4 Oocyte Aspiration Pump Failure

6.4.1 Management

6.4.1.1 Pump Checks

6.4.1.2 Tubing Checks

6.4.1.3 Needle Blockage

6.5 Excessive Pain during Oocyte Retrieval

6.6 Incidental Adnexal Pathology

Chapter 7 Complications of Oocyte Retrieval

7.1 Introduction

7.2 Haemorrhage

7.3 Pelvic Infection

7.4 Injury of Pelvic Structures

7.5 Vertebral Injury.

7.6 Summary

Chapter 8 The Nurse's Role during Oocyte Retrieval

8.1 Introduction

8.2 Planning Oocyte Retrieval

8.3 Sperm Sample

8.4 Documented Procedures: Oocyte Retrieval

8.5 Sedation

8.6 World Health Organization (WHO) Surgical Pathway

8.7 Resuscitation Equipment

8.8 Survey of Nurses Undertaking Pre-procedure Checklist

8.9 Trans People Undergoing Oocyte Retrieval

8.10 Undergoing Oocyte Retrieval for Fertility Preservation

8.11 The Oocyte Retrieval Process

8.12 Assessing Patient Well-Being

8.13 Risks of Oocyte Retrieval Procedure

8.14 Post-operative Care

8.15 Pre-discharge

8.16 Summary

Chapter 9 Laboratory Design, Equipment and Consumables for Oocyte Retrieval

9.1 Introduction

9.2 Laboratory Design

9.2.1 Process and Personnel Flow

9.2.2 Environmental Considerations

9.3 Equipment Considerations

9.3.1 Optimising the Oocyte Retrieval Workstation

9.3.2 Monitoring and Maintenance of Critical Equipment

9.4 Consumable and Reagent Requirements for TVOR

9.5 Identification of COCs in the Laboratory

9.6 Procedural Precision and Accuracy

9.7 Additional Equipment and Procedural Considerations

9.7.1 Considerations for TVOR for Virus-Positive Patients

9.7.2 Considerations for Offsite Oocyte Retrieval under a Transport IVF Arrangement

9.8 Summary

9.9 Final Thoughts: COVID-19

Chapter 10 Quality Management Requirements for Oocyte Collection

10.1 Quality Management in the IVF Unit

10.2 Top-Quality Egg Collections

10.2.1 Temperature Control and Equipment Validation

10.2.2 Equipment, Media and Consumable Selection

10.2.3 Laboratory Conditions

10.2.4 Reprotoxicity

10.2.5 Risk Assessment

10.2.6 Traceability and Witnessing

10.2.7 Supplier Accreditation

10.2.8 Operator Training and Competence.

10.2.9 Documentation

10.2.10 Process Validation

10.3 Performance Monitoring

10.3.1 Key Performance Indicators

10.3.2 Audit

10.4 Summary

Chapter 11 Morphological Assessment of Oocyte Quality

11.1 Introduction

11.2 Cytoplasmic Abnormalities

11.2.1 Morphological Appearance of the Cytoplasm

11.2.2 Centrally Located Granulation of the Cytoplasm

11.2.3 Refractile Bodies

11.2.4 Vacuoles

11.2.5 SERCs

11.3 Extracytoplasmic Abnormalities

11.3.1 Dysmorphic ZP

11.3.2 Discoloration

11.3.3 Shape Anomalies

11.3.4 PVS

11.3.5 First Pb Morphology

11.3.6 Debris in the PVS

11.4 Summary

11.5 Future Directions

Chapter 12 Oocyte Preparation for Conventional In Vitro Fertilisation and Intracytoplasmic Sperm Injection

12.1 Introduction

12.2 Initial Oocyte Preparation

12.3 Dish and Media Type

12.4 Pipette Use

12.5 Culture Media for COCs

12.6 Lessons from Transport IVF

12.7 Which Insemination Technique to Use

12.8 Should ICSI Be Performed for All Patients?

12.9 Timing of Insemination

12.10 Confirming Patient Identity and Record Keeping

12.11 Oocyte Preparation for cIVF

12.12 Oocyte Preparation for ICSI

12.12.1 Denudation of Cumulus-Corona Cells

12.12.2 Assessing Oocytes Prior to ICSI

12.13 Summary

Chapter 13 Oocyte Retrieval: The Patient's Perspective

13.1 Introduction

13.2 Information

13.3 Waiting for Egg Collection

13.4 Pain during Egg Collection

13.5 Handing over Control

13.6 The Pressure on the Male Partner

13.7 Care and Dignity

13.8 Calling Out the Number of Eggs

13.9 Delivering Results

13.10 Post-retrieval

13.11 Waiting and Anxiety

13.12 Grading of Embryos

13.13 To Blastocyst or Not

13.14 Fertility Preservation

13.15 Egg Donors

13.16 Summary

Index.

Notes:

Title from publisher's bibliographic system (viewed on 09 Nov 2022).

Includes bibliographical references and index.

ISBN:

9781108890731

1108890733

9781108892377

110889237X

9781108891646

1108891640