Practical tips for IVF/ET procedure

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In IVF/ICSI cycle, there are many unwritten clinical tips that u may get benefit if u consider during performing ovum pickup and embryo transfer

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Practical tips for IVF/ET procedure

  1. 1. Practical tips In IVF Hesham Al-Inany, M.D, PhD kaainih@yahoo.com
  2. 2. OPU: preparation • Test the OPU needle (nurse job) • Check pressure (120-160mmhg) • Check tube (fissured or intact : nurse job)
  3. 3. OPU: start • Stretch vaginal wall by ultrasound probe • Better lateral fornix (rather than posterior fornix) • Start at the middle line of the ovary (not the sides of the ovary) • Screw the needle (rather than push)
  4. 4. OPU : inside the follicle • Put the echotip of the needle in the CENTER of follicle • Twist the needle during collapse of the follicle • Gradual withdrawal of the needle slowly (always downwards) • Stay for few second after collapse of the follicle and twist the needle (follicular curettage
  5. 5. OPU: moving to another one • Slight movement downwards (do not exit the ovary) • Slight manipulation of the probe to get better view • Start from the base (horizontal direction rather than vertical direction) • Always Keep the echotip in view
  6. 6. OPU: precautions • Always keep in mind that the echotip is not the end of the needle: there is still few mm beyond the echo tip (actual tip)
  7. 7. • Start with a good responders) • Always try to avoid internal iliac artery • Start with the ovary with less follicles • Start using double lumen needle (rather than single lumen)
  8. 8. ET: RELAX • Joyful atmosphere • Try to be slow and gentle • Bladder preferred to be semifull or full • US guided ET is most preferred especially for beginners
  9. 9. ET • Good light • Speculum introduced to midvagina • Gently introducing the catheter • Either to start with firm catheter : easier • Or soft catheter : better results • Never touch the fundus
  10. 10. ET • Rest : minimum for 30 minutes • Better two hours • Avoid constipation • Regular movement
  11. 11. Always remember • Team work : u r not alone • Failure rate is higher than success • Success depends on age • Try to select ur cases at the start •Try to read more and more
  12. 12. How to ? • Obtain good results: monitor ur performance

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