What if all the Follicles were already Ruptured at the Time of Oocyte Pick-up in an IVF/ICSI Cycle? - Revista Brasileira de Ginecologia e Obstetrícia

What if all the Follicles were already Ruptured at the Time of Oocyte Pick-up in an IVF/ICSI Cycle? |

In vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatments are the assisted reproductive technologies (ARTs) with the highest success rate. In vitro fertilization and ICSI treatment have a high cost for couples including both the technology and the drugs used for ovulation induction. It is common to face prematurely ruptured follicles at the time of oocyte pick-up (OPU). The premature rupture of the follicles can happen due to many reasons such as idiopathic rupture of the follicles before the expected ovulation time, particularly in poor responder patients and inadvertent timing of ovulation trigger injections due to misunderstanding of the drug regimen. Also, it may be due to a delayed arrival to the ART clinic for OPU. There is a lack of data in the literature to salvage the IVF/ICSI cycles in such a situation after the use of high-cost injections for ovulation induction.

As we know from our basic knowledge about menstrual cycle physiology, after the rupture of the follicle, oocytes in the follicular fluid may be absorbed by the fallopian tubes with a negative pressure formed by the peristaltic movements of the tubes, directly or after spillage into the Douglas pouch. Therefore, following the rupture of the follicle, oocytes may be present in the peritoneal cavity, especially in the Douglas pouch, in the fallopian tubes, or in the uterus.

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