Today Monday Nov 30, 2020

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puncture


puncture operation:

IVF or ICSI has several steps, one of which is puncture or egg extraction . This stage can be done after the eggs have grown with hormone therapy. This operation usually does not require a surgical incision, and embryo extraction is done through the vaginal wall with ultrasound guidance and a needle. In this method, by perforating the wall of the follicles, their contents, which are eggs and follicular fluid, are removed.

پانکچر

 
By prescribing ovulation-stimulating drugs to a patient's ovaries, large numbers of egg-containing follicles grow and, after growth, are removed by puncture or ovulation. But in the puncture operation, only a limited number of individual eggs are taken, which does not seem to be a significant number compared to the hundreds of thousands of eggs in the ovary.
 
Normally, in each menstrual cycle, a number of ovarian follicles begin to grow, but in the process of growth, only one of the follicles reaches full maturity and is released from the ovary during the ovulation process, and the rest die in this way. Therefore, naturally, with the age of each woman, her ovarian reserve decreases.

What is an egg extraction or puncture operation?

egg extraction or puncture operation is a non-suture, non-suture operation that removes eggs from a woman's body. This operation is performed in 15 minutes without anesthesia

The word "surgery" may sound scary, but the process of recovering an egg is quick and basically painless. The doctor first uses ultrasound to identify the patient's ovaries, which are surrounded by clusters of small follicles. The needle attached to the ultrasound probe is then inserted into the uterus through the vaginal wall. The eggs are drawn one by one using light suction and collected in laboratory tubes with a unique name and identification number. The collected eggs are then transferred to the laboratory.

After completing the ovulation recovery process by removing the needle, the doctor examines the vaginal wall and ovaries. These sites may bleed a little, which uses a stimulant to prevent bleeding.

The patient is placed under local anesthesia, so he will not feel anything during the operation.

The anesthesiologist uses propofol-based anesthesia (it is not general anesthesia but is an intravenous sedative) to ensure that the patient does not feel any pain or discomfort during the egg recovery process.


Preoperative puncture procedures

 - One week before and two weeks after ovulation, intercourse is forbidden, especially in cases where the sex of the fetus is determined.

 - You will have a puncture (ovulation) 36 to 37 hours after the HCG injection. The day before the operation, have a light dinner at 8 pm, drink only water or tea until 12 noon, and fast completely from 12 pm until the operation.

 - If you are taking heart, blood pressure and thyroid medications, continue to take them as usual.

 - Get the necessary instructions if you have diabetes.

 - Take a bath the night before the operation and shave your body hair.

 - Avoid using cosmetics or nail polish on the day of surgery.


Postoperative puncture procedures if the fetus is not transferred

  • Take medications as directed by your doctor.
  • If nausea occurs, use the anti-nausea drug "metoclopramide".
  • Drink 2 to 3 glasses of fragrant buttermilk or orange juice a day.
  • Eat three boiled egg whites a day or 3 egg whites with a halved yolk.
  • Contact your doctor immediately if you experience severe nausea and vomiting, severe abdominal pain, bloating, or decreased urination.

 

Postoperative puncture procedures in case of transfer

* Empty the bladder 2 to 3 hours before transfer. Embryo transfer should be performed with a half-full bladder.

* You do not need to fast to transfer the fetus.

* Take a shower the night before to transfer the fetus.

* Intercourse is prohibited until prescribed by a doctor.


Freezing eggs after surgery

After the operation and before discharge, your doctor will tell you how many eggs have been recovered and taken to an embryology lab. Then, within 24 hours of the ovulation process, your doctor will call to let you know that many of the eggs have been frozen. Typically, about 80% of recovered eggs are mature, natural, and suitable for freezing.

After recovery, the eggs are immediately frozen in a specialized laboratory.

Mature oocytes go through the freezing process. Immediately after retrieving the egg, the embryologist washes the eggs and prepares them for freezing. Before the procedure, the embryologist removes the cells that surround the eggs. This allows him to see the eggs more clearly so that he can assess the quality and maturity of the eggs. Only mature and live eggs are frozen, because only with these eggs is proper fertilization performed. Typically, about 60-80% of recovered eggs are considered mature and suitable for freezing.