Short-term medical complications of 1500 oocyte retrievals for in vitro fertilization and embryo transfer

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Abstract

Objective: to evaluate the different short-term complications after in vitro fertilization and embryo transfer. Design: a retrospective study on 7 years in the fertility clinic of an university hospital. Materials and methods: short-term medical complications were analysed after 1500 transvaginal ultrasonographically guided oocyte retrievals. Results: ovarian hyperstimulation syndrome (1.8%), pelvic infections (0.4%), intraperitoneal bleeding (0.2%) and adnexal torsions (0.13%) were observed. One case of adnexal torsion occurred during pregnancy (0.18%). Two unusual case of bowel endometriosis were encountered (0.13%). Conclusions: short-term medical complications after in vitro fertilization and embryo transfer are rare (2.8%). This contrast with the high rate of multifetal pregnancies which increases maternal and perinatal morbidity and mortality and must be considered as the major complication of in vitro fertilization treatment.

Introduction

In vitro fertilization (IVF) is widely practised in most countries in the world today. It is therefore important to remember that medical complications may occur, either linked to ovulation induction or to the oocyte retrieval procedure. In contrast to complications related to pregnancies after IVF which are largely described [1]there is a scarcity of data about medical complications in IVF in the literature. In comparison to the general population, there are higher rates of ectopic, heterotopic and multiple pregnancies with their specific complications during pregnancy and delivery [2]. Congenital malformations after IVF [1]and chromosomal abnormalities after intracytoplasmic sperm injection (ICSI) [3]are still debated in the literature. The rate of medical complications during IVF is low but is important that it be known by each physician as he could be faced with them in his general practice. The aim of this study is to highlight the nature and the rate of different short-term medical complications encountered in our fertility clinic during IVF procedure.

Section snippets

Materials and methods

Complications of 1500 oocyte retrievals for IVF or ICSI with transcervical embryo transfer (ET) performed in our fertility clinic from 1989 to September 1996 were analyzed retrospectively. Fifteen cycles with zygote intrafallopian transfer and 30 cycles of oocyte donation were excluded because of the small number of cases and the differences in the medical risks for these populations. However, no complications were observed in these cases. Twenty nine hundred cycles of frozen and thawed embryos

Results

The different short-term observed complications are described hereunder in chronological order when the oocyte retrieval is performed.

Discussion

The rate of different short-term medical complications encountered in our fertility unit is low as described in the literature [2]. The different complications are reviewed under here.

Conclusions

IVF is currently considered as a potential solution for most long standing infertility problems. Nevertheless each gynecologist has to remember that the practice of reproduction treatments is associated with a wide range of complications that may endanger these young and healthy patients. Fortunately the rate of these complications is low. Some guidelines could be reduce the rate of complications after IVF.

Unfortunately since the first description of OHSS 30 years ago, the pathophysiology

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