Objective: To report a successful case of magnetic resonance imaging (MRI)-guided oocyte retrieval in a patient with challenging pelvic anatomy, extensive adhesive disease, and diminished ovarian reserve, necessitated by the inability to visualize the ovaries using transvaginal or transabdominal ultrasound.
Design: Case report.
Subject: A 33-year-old nulligravid woman with a history of ulcerative colitis, multiple pelvic and abdominal surgeries, and significant pelvic adhesive disease.
Exposure: Controlled ovarian stimulation was initiated using a gonadotropin-releasing hormone antagonist protocol, followed by sequential MRI and MRI-guided oocyte retrieval due to challenges in visualizing and accessing the ovaries.
Main outcome measures: Successful oocyte retrieval under MRI guidance.
Results: Two oocytes were retrieved from 5 aspirated follicles using MRI guidance. Both underwent intracytoplasmic sperm injection, resulting in the development of a single blastocyst, which led to a live birth via embryo transfer to a gestational carrier.
Conclusion: Magnetic resonance imaging-guided oocyte retrieval represents a potential technique for patients with complex pelvic anatomy or extensive adhesive disease, where traditional ultrasound-guided approaches may be inadequate. Interdisciplinary collaboration and individualized care are crucial in optimizing outcomes for patients undergoing assisted reproduction, particularly those with challenging medical histories. Further studies comparing MRI-guided and traditional ultrasound-guided oocyte retrieval in challenging cases are warranted to determine the optimal approach for these patients.
Keywords: Adhesions; case report; in vitro fertilization; magnetic resonance imaging; oocyte.
© 2025 The Authors.