The incidence of major clinical complications in a Dutch transport IVF programme

Abstract

Four different major clinical complications were identified in a retrospective analysis of 2495 in-vitro fertilization (IVF) cycles resulting in oocyte retrieval. The severe form of ovarian hyperstimulation syndrome (OHSS) occurred in 18 patients, giving a prevalence for this complication of 0.7%. Seven (39%) of these 18 patients had previously been diagnosed as having polycystic ovaries. Eleven patients were admitted with moderate OHSS. Adnexal torsion was diagnosed in two patients. Ovariectomy was considered necessary in both cases. Complications of the transvaginal procedure occurred in seven cases (0.3%): one patient had an acute appendicitis with puncture holes in the appendix, six patients were admitted shortly after oocyte retrieval with a pelvic inflammatory disease. Of the 624 pregnancies obtained, 13 were ectopic, giving an ectopic pregnancy rate of 2.1%. It is concluded that serious clinical complications of IVF treatment are rare. However, patients should be counselled for the occurrence of serious procedure-related complications before entering an IVF programme.

Actinomyces urogenitalis Bacteremia and Tubo-Ovarian Abscess after an In Vitro Fertilization (IVF) Procedure

“…However, the incidence is generally low and varies between 0.03% and 1.3% (7,(21)(22)(23)(24)(25)(26)(27). Transvaginal inoculation of bacteria into the peritoneal cavity or ovary by the collecting needle is the most apparent source of these infections (23,28,29).…”

Evaluation of complications developing during and after transvaginal ultrasound — guided oocyte retrieval

“…Akman et al and Roest et al reported perforated appendicitis in two patients after OPU, and the needle hole was observed in these cases [25,26]. Contrary to what is believed, intestinal injury is less common, and is more likely to develop in patients with advanced endometriosis, previous surgery, or pelvic adhesions related to previous infections [27].…”

“…In their series of 2.495 patients, Roest et al detected pelvic infection in six (0.24%) patients. These six patients were treated with appropriate antibiotics [26]. Askenazi et al [31] found pelvic infection in 28 of 47.771 patients (0.58%).…”

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

“…6 Proflaktik antibiyotik kullanımını öneren kanıta dayalı bir rehber bulunmasa da doksisiklin, metronidazol ya da birinci kuşak sefalosporinleri OPU öncesi profilaktik dozda kullanarak ya da OPU günü ve sonrasında kullanılmak üzere 5 gün-lük antibiyoterapi rejimi düzenleyerek enfeksiyonu azalttıklarını bildiren farklı çalışmalar bulunmaktadır. [7][8][9] Bu konudaki tek ortak görüş ise daha ön-ceden PIH geçirmiş ya da endometrioması olan hastalar gibi yüksek riskli hastalarda antibiyotik kullanılması gerekliliğidir. 10 Bu hastalarda pelvik abse ile sonuçlanabilen enfeksiyonlar bildirilmektedir.…”