Chapter 8 – Ultrasound-Guided Procedures




Abstract




The vaginal probe is covered in a sterile plastic sheath, with an attached needle guide. The guide is used to align with each follicle at its largest diameter. A 16–17-gauge needle is used to aspirate the fluid with the oocyte.





Chapter 8 Ultrasound-Guided Procedures




Oocyte Retrieval


Transvaginal aspiration, guided by ultrasonography, is now a standard technique for oocyte retrieval.


The vaginal probe is covered in a sterile plastic sheath, with an attached needle guide. The guide is used to align with each follicle at its largest diameter. A 16–17-gauge needle is used to aspirate the fluid with the oocyte.





Figure 8.1 Needle guide attached to the TV probe.


Abdominal pressure can be used to stabilise the ovary or to move it to a more convenient location for aspiration.


Serious complications of oocyte retrieval are uncommon. Ultrasound provides visibility of the needle within the ovary and helps limit discomfort and ovarian trauma. (Figures 8.1, 8.2, 8.3)





Figure 8.2 The image is inverted during the oocyte retrieval procedure. The needle tip can be positioned using the needle guide to align each follicle.


Courtesy of R Gallagher, IVFAustralia




Figure 8.3 Needle tip can be seen within the follicle.


Courtesy of R Gallagher, IVFAustralia


Embryo Transfer


Transabdominal scanning for catheter insertion into the uterus requires the beam to be focused on the cervix and lower uterine cavity. The bladder needs to be partially filled. The catheter is seen as an echogenic linear structure and the tip can be seen moving through the endometrial canal. Minor adjustments of the angle of the beam are required to maintain the image of the catheter.





Figure 8.4 The catheter is seen as an echogenic line, within the endometrial cavity.





Figure 8.5 Transfer of the blastocyst using transabdominal scanning. The catheter can be followed during real-time imaging within the body of the uterus, seen here as echogenic dots within the body of the uterus.


Feb 23, 2021 | Posted by in GYNECOLOGY | Comments Off on Chapter 8 – Ultrasound-Guided Procedures
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