Severe haematoperitoneum caused by ovarian bleeding after transvaginal oocyte retrieval: A retrospective analysis and systematic literature review

Abstract

A case series of haematoperitoneum caused by ovarian bleeding after transvaginal oocyte retrieval (TVOR) is presented and all published cases summarized. In a retrospective case series, four patients with ovarian bleeding after TVOR were included. In addition, a pooled analysis of all published cases (n = 32) who underwent surgical intervention for severe haematoperitoneum caused by ovarian bleeding after TVOR was carried out. Main outcome measures were incidence, risk factors, course and intraoperative findings. In the pooled analysis, the incidence was 0.08%. The first sign of haematoperitoneum was evident in 33.3% within the first postoperative hour, and, cumulatively, in 93.3% within 24 h. The median time between TVOR and surgical intervention was 10 h. In four patients, the ovary could not be preserved, which was associated with a longer time interval between TVOR and the onset of symptoms (median 18 h versus 2.5 h; P = 0.004) as well as between TVOR and surgical intervention (median 21.5 h versus 8.5 h; 0.004). In conclusion, severe haematoperitoneum occurs in 0.08% after TVOR. Late-onset bleeding is common. A longer time interval between TVOR and surgical intervention might put a patient at risk of ovariectomy.

Severe hemoperitoneum resulting from restart of letrozole after oocyte retrieval procedure: a case report

“…The incidence of severe hemoperitoneum was 0.08% in 2007, decreasing 0.29-fold by 2015 in Japan [ 8 ]. Severe hemoperitoneum symptoms usually appear within 24 hours after oocyte retrieval procedures [ 9 ].…”

Ponavljajuća ruptura jajnika – komplikacija medicinskog postupka ili upozorenje na povećane rizike za nepovoljan ishod u reprodukcijskoj dobi? Prikaz slučaja

“…The presented case indicated a group of patients who are more prone to complications in different circumstances of reproductive age. Key words: hemoperitoneum; in vitro fertilization; ovarian cyst; preterm labor renja uključuje kirurški zahvat u općoj anesteziji radi postizanja hemostaze i vitalnog zbrinjavanja pacijentice, što je ozbiljna posljedica uobičajeno jednostavnog liječenja neplodnosti, koje se obavlja ambulantno 5 . U ovome članku bit će prikazan slučaj pacijentice s ponavljajućom rupturom jajnika -prvi put nakon aspiracije jajnih stanica u stimuliranom IVF ciklusu, a zatim nakon dugog vremenskog razdoblja drugi put, nakon prijenosa zametka u prirodnom ciklusu.…”

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

“…10 Severe hemoperitoneum, 10,11 massive hematuria, 12 rupture of ovary causing hemorrhagic shock 13 and uterovaginal fistula formation 14 have been reported as OPU-related complications. Aragona et al reported the incidence of severe complications and intraperitoneal bleeding, in their 7,098 IVF cycle series, to be 0.08% and 0.06%, respectively.…”