Appraisal of clinical complications after 23,827 oocyte retrievals in a large assisted reproductive technology program

Oocyte retrieval complications are related to the number of follicles, oocytes, body mass index, mean time per oocyte retrieved, and clinician experience.

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Volume 109, Issue 6, Pages 1038–1043.e1

Authors:

Paolo Emanuele Levi-Setti, M.D., Federico Cirillo, M.D., Valeria Scolaro, M.D., Emanuela Morenghi, Ph.D., Francesca Heilbron, M.D., Donatella Girardello, M.D., Elena Zannoni, M.D., Pasquale Patrizio, M.D., M.B.E.

Abstract:

Objective

To assess complications encountered after transvaginal oocyte retrieval procedures.

Design

Retrospective analysis.

Setting

University hospital, fertility center.

Patient(s)

A total of 23,827 consecutive transvaginal oocyte retrieval procedures in 12,615 patients.

Intervention(s)

Oocyte retrieval procedures performed between June 1996 and October 2016.

Main Outcome Measure(s)

All oocyte retrieval complications. Those requiring hospital admission for at least 24 hours were considered severe.

Result(s)

A total of 96 patients (0.76 %) suffered complications, with hospital admission necessary for 71 patients (0.56 %). When calculated per retrieval, the overall complication rate was 0.4%, whereas 0.29% was the admission rate, with an average duration of hospital stay of 2.77 ± 2.5 days. A surgical procedure was necessary for 24 patients (0.1% per retrieval and 0.19% per patient). Multivariate analysis showed a significant correlation between complications and women age, body mass index (BMI), the number oocyte retrieved, and the mean time to complete oocyte retrieval. The incidence of complications was significantly higher for physicians who had performed <250 retrievals compared with those who had completed >250 retrievals (odds ratio 0.63, 95% confidence interval 0.40–0.99).

Conclusion(s)

Oocyte retrieval can be considered a safe procedure but is not without risks. The most important, identifiable, risk factors for the occurrence of complications are: [1] high number of oocytes retrieved, [2] a long duration of the procedure and mean time per oocyte retrieved, [3] inexperience of the surgeon, [4] younger patients with a lesser BMI, and [5] history of prior abdominal or pelvic surgery or pelvic inflammatory disease.

Clinical Trial Registration Number

NCT03282279.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

1 Comments

Go to the profile of Selwyn Oskowitz
Selwyn Oskowitz 6 months ago

Reassuring work from Patrizio’s team. How about the age of the surgeon?