Transvaginal oocyte retrieval

Transvaginal oocyte retrieval (TVOR), also referred to as oocyte retrieval (OCR), is a technique used in in vitro fertilization (IVF) in order to remove oocytes from the ovary of a woman, enabling fertilization outside the body. Transvaginal oocyte retrieval is more properly referred to as transvaginal ovum retrieval when the oocytes have matured into ova, as is normally the case in IVF.

Under ultrasound guidance, the operator inserts a needle through the vaginal wall and into an ovarian follicle, taking care not to injure organs located between the vaginal wall and the ovary. The other end of the needle is attached to a suction device. Once the follicle is entered, suction is gently applied to aspirate follicular fluid and with it, hopefully, cellular material including the oocyte. The follicular fluid is delivered to a technician in the IVF laboratory to identify and quantify the ova. Next, other follicles are aspirated. Once the ovarian follicles have been aspirated on one ovary, the needle is withdrawn, and the procedure repeated on the other ovary. It is not unusual to remove 20 oocytes as women are generally hyperstimulated in advance of this procedure. After completion, the needle is withdrawn, and hemostasis is achieved. The procedure usually lasts 20–60 minutes.

Initially performed using transabdominal ultrasonography, TVOR is currently performed with a transvaginal ultrasound transducer with an attached needle. TVOR is performed in an operating room or a physician's office, with the (female) subject in the lithotomy position. TVOR is usually performed under procedural sedation,general anesthesia,paracervical block, or sometimes spinal anesthesia.Local anesthesia is not typically used because local anesthetic agents interfere with follicular cleavage and the technique requires multiple needle punctures.

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