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

作者：Levi Setti Paolo Emanuele^*; Cirillo Federico; Scolaro Valeria; Morenghi Emanuela; Heilbron Francesca; Girardello Donatella; Zannoni Elena; Patrizio Pasquale

来源：Fertility and Sterility, 2018, 109(6): 1038-+.

DOI：10.1016/j.fertnstert.2018.02.002

• Oocyte retrieval
• complications
• vaginal and peritoneal bleeding
• pelvic sepsis

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 WO. 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, 950/0 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.

• 出版日期2018-6