New technique that helps obtain eggs in women with ovarian failure

Digital sonographic folliculoscopy is a new technique that allows obtaining eggs in women with severe ovarian failure.

Developed by doctors Jan Tesarik and Raquel Mendoza Tesarik, directors of the MARGen Clinic in Granada, Spain, the new technique has been unveiled in a study published in the International Journal of Gynaecology and Obstetrics that collects the results obtained in 85 women between 35 and 42 years old, patients of the MARGen clinic.

All the patients in the study showed an extremely low response to ovarian stimulation and had previously suffered a total failure in the retrieval of eggs using the follicular puncture technique within an in vitro fertilization (IVF) treatment, a condition called “white puncture” . A result that is usually justified by an absence of eggs within the aspirated follicles, “empty follicle syndrome”.

However, in most cases this is not the case, according to the experience of researchers from Granada. The team at the MARGen Clinic used a new non-invasive technique, called digital sonographic folliculoscopy, which allowed the identification of a cumulus oophorus (a formation of cells that houses an egg) in most of the follicles of these women. This means that these follicles were not empty and that the standard aspiration force had not been sufficient to separate the cumulus oophorus with its ovum from the follicular wall.

According to the study authors, the triggering of ovulation with a single dose of chorionic gonadotropin (HCG) was insufficient to relax the adhesion between the cumulus oophorus and the follicular wall, and they applied a second dose of HCG, 12 hours after the first , in patients who wanted to repeat, despite initial failure. In the second attempt, it was possible to extract eggs from between 90 and 94 percent of the follicles in which their presence had been identified through the digital folliculoscopy previously performed.

Specifically, in women with 1, 2, and 3 follicles with a cumulus oophorus detected by digital folliculoscopy, the success rate was, respectively, 94%, 93%, and 90%. None of the women developed more than 3 follicles, due to their ovarian failure condition. The success of this new technique can be explained by the fact that the HCG hormone not only triggers the final maturation of the eggs, but also promotes the relaxation of the contact of the eggs with the wall of the follicles.

With the help of this new technique, healthy childbirths were obtained in cases that, otherwise, would have been annulled by a “white puncture” (total absence of ovules in the fluid aspirated from the follicles).

According to doctors Tesarik and Mendoza-Tesarik, “thanks to our sonographic folliculoscopy technique, we were able to verify that most of the follicles in which an ovum had not been aspirated were not really empty, but rather that the ovum was stuck, by means of the cells of the cumulus oophorus that surround it, to the follicular wall so firmly that the force of follicular aspiration could not separate it ”.

In addition to confirming the usefulness of the new digital sonographic folliculoscopy technique, previously developed and published by the MARGen clinic team, the novelty of the study is that the repetition of the injection of HCG (a hormone that triggers ovulation), 12 hours after the first, it solves the problem and enables successful IVF in women whose treatment would have been canceled with the standard protocol. (Source: MARGen)

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