Discomfort and complications related to oocyte retrieval: a prospective cohort study

Abstract

Although transvaginal ultrasound-guided oocyte retrieval (OR) became the gold standard for IVF treatment, due to its simplicity, there is very little systematic data on the tolerability and incidence of its complications. Moreover, registry data are dependent on the compliance of the centers to report it and often is neglected. Thus, we assessed the safety and tolerability of OR in a large prospective study. Prospective trial. 1628 ORs performed from September 2008 until April 2011 included in this study. Each woman was asked to complete on the day of OR a questionnaire and return it on the day of ET and also to be contacted 2 months later in order to evaluate the procedure. A second questionnaire was completed by the performing physician regarding his experience on ORs, the possible complications during anesthesia and following OR and also a follow up after 2 months. The majority of OR was performed with local anesthesia (90.23%).Vaginal bleeding was observed in 2.45% of procedures while two cases of mild intra-abdominal bleeding was occurred. No case of injury of pelvic structures was observed. Perioperative antibiotic prophylaxis was administrated in 2.9% of cases while infection was observed in 5 cases. Severe OHSS occurred in 1.2 % of the cases. Although most patients tolerated the OR well, 4.2% of patients experienced severe pain and required extra painkillers and 3.2% of patients were still suffering from severe pain 2 days after the OR. The pain level increased with the number of oocytes retrieved and the difficulty during the OR. Only 0.4% of patients required hospitalization for pain treatment. This is the larger prospective study following the complications during the OR and a post-operative interval of two months in a standardized manner. Based on our findings, OR is a quite safe procedure, however patients must be informed about the risk of possible minor complications. Moreover, a well-informed patient tends to experience less pain and discomfort.