CPT® Code 58970

1. Indications

The procedure of follicle puncture for oocyte retrieval is indicated for patients undergoing in vitro fertilization (IVF) who require the collection of oocytes for fertilization. The following conditions may warrant this procedure:

• Infertility Patients experiencing difficulties in conceiving naturally may be candidates for IVF, necessitating oocyte retrieval.
• Ovarian Hyperstimulation In cases where ovarian stimulation has been performed to produce multiple follicles, oocyte retrieval is essential to collect the matured eggs.
• Assisted Reproductive Technology (ART) Patients participating in ART protocols often require oocyte retrieval as part of their treatment plan.

2. Procedure

The procedure for follicle puncture for oocyte retrieval involves several critical steps to ensure successful egg collection. Each step is designed to maximize the chances of retrieving viable oocytes while minimizing risks to the patient.

• Step 1: Patient Preparation The patient is prepared for the procedure, which includes obtaining informed consent and ensuring that the patient is in a comfortable position, typically in a gynecological examination position. Monitoring of vital signs may also be conducted to ensure the patient's stability.
• Step 2: Imaging Guidance The physician utilizes ultrasound or laparoscopic guidance to visualize the ovarian follicles. This imaging is crucial for accurately locating the follicles that contain the oocytes, allowing for precise needle placement.
• Step 3: Needle Insertion A specialized needle is carefully inserted through the vaginal wall (in the case of transvaginal access) or through the abdominal wall (in the case of transabdominal or laparoscopic access) directly into the identified follicle. The physician ensures that the needle is positioned correctly to aspirate the egg and surrounding fluid.
• Step 4: Aspiration Once the needle is in place, the physician aspirates the follicular fluid, which contains the oocyte. This step is performed with precision to ensure that the egg is successfully retrieved without damaging surrounding tissues.
• Step 5: Withdrawal of Equipment After the aspiration is complete, the needle and any other medical instruments used during the procedure are carefully withdrawn from the body.
• Step 6: Closure (if necessary) Depending on the method of access and the physician's assessment, closure of the puncture site may be performed using adhesive strips to promote healing and minimize the risk of complications.

3. Post-Procedure

After the follicle puncture for oocyte retrieval, patients are typically monitored for a short period to ensure there are no immediate complications. Post-procedure care may include instructions on activity restrictions, such as avoiding strenuous exercise or sexual intercourse for a specified period. Patients may also be advised to watch for signs of complications, such as excessive bleeding or severe pain, and to report any concerns to their healthcare provider. Follow-up appointments may be scheduled to discuss the results of the oocyte retrieval and the next steps in the IVF process.