A randomized trial of laparoscopy and transvaginal ultrasound-directed oocyte pickup for in vitro fertilization.

Ninety-four (94) couples undergoing IVF for the usual spectrum of clinical reasons and who were suitable for either laparoscopic or vaginal ovum pickup (OPU) were randomly assigned at the commencement of 166 treatment cycles to one of two OPU procedures. Both patient and clinician were informed of the allocation. If either wished to change this, then that cycle was eliminated from the trial. After a period of 15 months, 103 cycles were appropriate for analysis, of which 64 had been subject to ultrasound and 39 to laparoscopic OPU. Patients in the two groups did not differ significantly in terms of age or diagnosis, and the treatment cycles did not differ significantly in terms of stimulation used, commencing or maximum estradiol (E2) concentrations, E2 per follicle aspirated, or characteristics of the semen used for IVF. The rate of oocyte recovery (number of oocytes obtained per follicle aspirated), the average number of embryos available for transfer, and the pregnancy rate per oocyte recovery procedure did not differ significantly in the two groups. Ovum recovery for IVF using vaginal aspirations and ultrasound guidance is as efficacious as that which uses laparoscopy.