Intraperitoneal bleeding following transvaginal oocyte retrieval

Abstract

Patients with severe intraperitoneal bleeding had a lower body mass index, a history of surgery, were younger, and had a moderate ovarian response; those with mild bleeding were young and had a high ovarian response.

Minimizing the Risk of Infection and Bleeding at Trans-Vaginal Ultrasound-Guided Ovum Pick-up: Results of a Prospective Web-Based World-Wide Survey

“…The most common complication is minor vaginal bleeding (1.4-18.4 %) secondary to accidental injury to the vaginal vessels [1]. The risk of pelvic infection (0.1-0.6 %) [2] and severe intraabdominal bleeding (0.05-0.2 %) [2][3][4][5] is very low. Though severe intra-abdominal bleeding usually occurs as a result of injury to sub-capsular ovarian vessels or small intra-follicular vessels [1], injury to pelvic vessels and coagulation abnormalities can also cause hemoperitoneum and retroperitoneal bleeding [6][7][8][9].…”

“…Siristatidis et al [11] reported that four out of 542 women (0.74 %) who underwent TV-OPU were found to have abnormal platelets, and Fatum et al [12] reported of eight women in a cohort of 1,800 women (0.44 %) who had bleeding tendency disorder. While some units have a protocol of screening women routinely for coagulopathy [11] and some studies have emphasized the importance of undertaking coagulation profile before the procedure [5], a cross-sectional retrospective study [13] identified the need to screen 534 women for coagulation defects to prevent one case of excessive bleeding associated with abnormal coagulation.…”

“…However, in their retrospective analysis of 3,241 women undergoing TV-OPU, Liberty et al [14] found that all the seven women who had significant ovarian hemorrhage were lean with a body mass index (BMI) of 19-21 kg/m 2 . Zhen et al [5], in their retrospective analysis of 10,251 IVF cycles, reported five women (0.05 %) with severe intra-peritoneal bleeding and 17 women (0.17 %) with mild intra-peritoneal bleeding. They found that the women who had severe bleeding following the procedure had significantly lower BMI when compared to women with mild or no intra-abdominal bleeding.…”

Embryo Transfer and Oocyte Pick Up Related Complications of In Vitro Fertilization

“…16 Ancak Zhen ve ark.nın çalışmasında BMI 19-21 arasında olan zayıf kadınlarda kanama riskinin daha yüksek olduğu izlenmektedir. 17 Kanamayı engellemenin en kolay yolu müm-kün olduğunca az vajinal girişimde bulunmaktır. İşlem öncesi USG ile aspirasyonu planlanan foliküllerin gözlemlenmesi ve mümkünse renkli doppler ile muhtemel kan damarı komşuluklarının incelenmesi yardımcı olacaktır.…”

Does the number of prior oocyte retrieval practices increase the amount of blood loss in subsequent OPU procedures?

“…In this context, it is unclear whether, or not, history of a prior OPU, similar to the history of a surgery, 9 pose any risk of increased blood loss in the course of OPU. We, herein, aimed to determine whether mean blood loss and hematologic parameters vary between women with and without the history of an oocyte retrieval procedure, in a non-anemic, unexplained infertility population who underwent OPU under general anesthesia, following controlled ovarian stimulation (COS).…”