What is the follicular puncture of a fiv process?
Follicular puncture, also known as ovarian puncture, is one of the fundamental steps of in vitro fertilization (IVF). It is a surgical intervention whose objective is to obtain the ovules inside the follicles of the ovary. It is a simple and short-term process that is performed under anesthesia (sedation).
Below you have an index with all the points that we will discuss in this article.
Index
What is the follicular puncture of an IVF process?- 1. Follicular aspiration step by step
- 1.1. Patient's admission
- 1.2. Anesthesia
- 1.3. Follicular aspiration
- 1.4. Recovery and rest
- 2. Possible risks and side effects
- 3. Recommendations for puncture
- 4. Questions from users
- 4.1. Do you feel pain in the follicular puncture?
- 4.2. In what cases is the ovarian puncture done?
- 4.3. Can the follicular puncture be done without anesthesia?
- 4.4. Is it normal to have abdominal pain after follicular puncture?
- 4.5. Is the ovarian puncture the same in IVF as in ICSI?
Follicular aspiration step by step
In a natural way, each month, an egg leaves the ovary in the process known as ovulation. When we perform an IVF cycle, the patient receives a hormonal treatment of ovarian stimulation to promote the maturation and ovulation of the largest possible number of ovules.
However, in order to fertilize the ovules in the laboratory, we must obtain them before they leave the ovary spontaneously and we can not locate them. Therefore, follicular puncture should be performed just before natural ovulation.
Since the objective is to extract the ovules when they are in a maturational state that allows fertilization (metaphase II), it is essential to schedule the puncture at the appropriate time. For this, during the stimulation treatment, follicular growth is controlled by measuring the size of the follicles by transvaginal ultrasound and the concentration of the hormone estradiol in the blood.
The patient should go to these controls approximately every two days. If you want more information about this step you can click here: controlled ovarian stimulation.
It is said that a follicle is mature, that is, it contains a mature ovum inside, when it has a diameter greater than 16-18 mm. When it is observed that the follicles have reached this size, the woman is administered the hormone hCG, which favors the final maturation of the ovules and triggers the ovulation between 36 and 48 hours after its administration.
Thus, we schedule the puncture a few hours before ovulation, that is, between 30 and 34 hours after the patient injects the hCG. This way, we will get the ovules inside the follicles at the moment of the intervention.
Control of stimulation and programming of ovarian punctureAlthough there may be variations between some centers and others, in a generalized way, the steps of this process are:
Patient's admission
The patient enters the center on the same day, approximately one hour before the operation. You must take with you the preoperative study and the pre-anesthetic review that the specialists will have done previously.
It is important that the patient is calm and fasting, at least during the 6 hours prior to the intervention. You should know that it is a simple and short-term operation (30 minutes approx.) And that same day you can return home.
Anesthesia
The patient enters the operating room on her own foot and is placed in a gynecological position. Next, the anesthetist administers the sedation.
It is not a complex intervention but requires anesthesia to avoid pain and make extraction more comfortable for the gynecologist.
Follicular aspiration
Once asleep, the gynecologist starts the follicular aspiration guided by ultrasound. Enter the ultrasound that incorporates the aspiration needle and goes puncturing the ovarian follicles and aspirate the liquid content.
This liquid, in which the ovules float, goes directly to the test tubes, which are at a temperature of 37 ° C. While maintaining the temperature, the tubes are transferred to the laboratory, where the embryologists will analyze it in search of mature ovules.
The mature ovules obtained will be fertilized until they give rise to viable embryos, which can be implanted after being transferred to the maternal womb.
Recovery and rest
When the gynecologist has already punctured all the follicles that he considers mature, the anesthesia is eliminated and the patient is moved to a room. There, it will remain a few hours at rest, recovering from the effects of anesthesia.
After this time and after checking that everything is fine, the patient returns home. It is possible that that same day you feel small discomforts derived from the intervention but generally, they will not prevent you from continuing with your usual routines the next day.
Possible risks and side effects
Ovarian aspiration is a simple surgery that is performed under mild anesthesia or intravenous sedation. Therefore, the risks that can be derived are low. Anesthesia may lead to side effects such as discomfort, dizziness, low blood pressure or vomiting, but this happens very rarely.
As for the intervention itself, one of the main risks that can arise is the injury to the pelvic organs, which in turn can cause hemorrhage and pelvic infection.
To avoid possible complications, it is important that the gynecologist makes an adequate ultrasound inspection of the pelvis to rule out the accumulation of blood in the bottom of the Douglas pouch.
Recommendations for puncture
One of the essential requirements so that the puncture proceeds normally and does not imply secondary or unforeseen effects, is absolute fasting. Do not drink or eat during the 6 hours before the puncture.
It is advisable to go accompanied to the clinic, since, due to sedation, the woman may feel disoriented after the intervention.
The woman can leave the center shortly after the puncture. It is advisable to wait a reasonable time of a few hours to recover from local anesthesia.
Discomfort or small vaginal bleeding may occur after the intervention. It is best to be on that same day of rest and not make great efforts to give the body time to recover completely.
Questions from users
Do you feel pain in the follicular puncture?
No, the follicular puncture is done under anesthesia and therefore the patient does not feel pain. You may notice slight discomfort before the intervention due to the increase in the size of the ovaries caused by ovarian stimulation.
In what cases is the ovarian puncture done?
Ovarian puncture is performed when it is necessary to extract the ovary from the ovary, either to undergo an in vitro fertilization, or for an egg donation. Follicular puncture is also performed when a woman wants to preserve her fertility, since this means obtaining and later vitrifying the ovules.
Can the follicular puncture be done without anesthesia?
It could be done, but it would be very painful for the woman. In addition, due to the pain in the patient, the gynecologist could not perform the aspiration well, so the results would be worse, the possible complications would increase and the intervention time would be prolonged.
Is it normal to have abdominal pain after follicular puncture?
Yes, many women feel small discomfort in the abdominal and vaginal area due to the intervention. The usual thing is that the pain is felt the same day of the puncture and perhaps also the next day, but it will diminish until disappearing as the days pass from the puncture.
Is the ovarian puncture the same in IVF as in ICSI?
Yes, conventional in vitro fertilization and ICSI only differ at the time of actual fertilization, that is, in the way of fusing the ovule and the sperm, but the rest of the steps of the process are the same.
Ovarian stimulation, follicular puncture, embryo culture and embryo transfer do not change. You can get more information here: conventional IVF and ICSI.
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