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

Özkan Özdamar, İsmet Gün, Ali Ovayolu, Kenan Sofuoğlu


Background: Though OPU is a safe and simple procedure, it may cause damage to pelvic structures and bleeding. It is unclear whether history of a prior OPU poses any risk of increased blood loss in the OPU. We, herein, aimed to evaluate whether mean blood loss and hematologic parameters vary between women with and without the history of an OPU, in an unexplained infertility population.

Methods: A prospective case-control study was conducted through the files of patients who underwent IVF/ICSI-ET between June and December 2013. Unexplained infertility patients with a CBC result were assigned to two groups; those undergoing OPU for the first time (Group 1, n=40) and those who were previously subjected to at least 1 procedure (Group 2, n=13). Blood samples were obtained before the ET. Hemoglobin values and changes were compared between the two groups.

Results: Delta hemoglobin value did not significantly differ between the groups (p=0.469) and there were no significant difference between the pre- and post-procedure hemoglobin values in the patients with no and at least one OPUs and the total patient population (p=0.792, 0.259 and 0.442, respectively).

Conclusions: Our study results reveal that the amount of the blood loss in OPU does not significantly vary between women subjected to the procedure for the first time and for more than 1 time.



Oocyte retrieval, In-vitro fertilization, Hemorrhage, Hemoglobin

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Siristatidis C, Chrelias C, Alexiou A, Kassanos D. Clinical complications after transvaginal oocyte retrieval: a retrospective analysis. J Obstet Gynaecol. 2013;33:64-6.

Battaglia C, Regnani G, Giulini S, Madgar L, Genazzani AD, Volpe A. Severe intra-abdominal bleeding after transvaginal oocyte retrieval for IVF-ET and coagulation factor XI deficiency: a case report. J Assist Reprod Genet. 2001;18:178-81.

Bennett SJ, Waterstone JJ, Cheng WC, Parsons J. Complications of transvaginal ultrasound-directed follicle aspiration: a review of 2670 consecutive procedures. J Assist Reprod Genet. 1993;10:72-7.

Orvieto R, Ben Rafael Z. Bleeding, severe pelvic infection and ectopic pregnancy following ART. In: Gardner DK, Weissman A, Howles C, Shoam Z, editors. Textbook of assisted reproductive techniques: volume 2: Clinical Perspectives. 4th Edition. London, UK: informa healthcare; 2012:374-81.

Ragni G, Scarduelli C, Calanna G, Santi G, Benaglia L, Somigliana E. Blood loss during transvaginal oocyte retrieval. Gynecol Obstet Invest. 2009;67:32-5.

Moayeri SE, Coutre SE, Ramirez EJ, Westphal LM. Von Willebrand disease presenting as recurrent hemorrhage after transvaginal oocyte retrieval. Am J Obstet Gynecol. 2007;196:e10-1.

El-Shawarby SA, Margara RA, Trew GH, Laffan MA, Lavery SA. Thrombocythemia and hemoperitoneum after transvaginal oocyte retrieval for in vitro fertilization. Fertil Steril. 2004;82:735-7.

Ferraretti AP, Goossens V, Kupka M, Bhattacharya S, de Mouzon J, Castilla JA et al. European IVF-monitoring (EIM) consortium for the European Society of Human Reproduction and Embryology (ESHRE). Assisted reproductive technology in Europe, 2009: results generated from European registers by ESHRE: Hum Reprod. 2013;28:2318-31.

Zhen X, Qiao J, Ma C, Fan Y, Liu P. Intraperitoneal bleeding following transvaginal oocyte retrieval. Int J Gynaecol Obstet. 2010;108:31-4.

Nouri K, Walch K, Promberger R, Kurz C, Tempfer CB, Ott J. Severe haematoperitoneum caused by ovarian bleeding after transvaginal oocyte retrieval: a retrospective analysis and systematic literature review. Reprod Biomed Online. 2014;29:699-707.

Kart C, Guven S, Aran T, Dinc H. Life-threatening intraabdominal bleeding after oocyte retrieval successfully managed with angiographic embolization. Fertil Steril. 2011;96:e99-102.

Jayakrishnan K, Raman VK, Vijayalakshmi VK, Baheti S, Nambiar D. Massive hematuria with hemodynamic instability-complication of oocyte retrieval. Fertil Steril. 2011;96:e22-4.

Bandyopadhyay S, Kay V. A rare case of rupture of ovary causing haemorrhagic shock following uncomplicated oocyte retrieval-a case report. Hum Fertil (Camb). 2010;13:105-6.

Mongiu AK, Helfand BT, Kielb SJ. Ureterovaginal fistula formation after oocyte retrieval. Urology. 2009;73:444.e1-3.

Aragona C, Mohamed MA, Espinola MS, Linari A, Pecorini F, Micara G et al. Clinical complications after transvaginal oocyte retrieval in 7,098 IVF cycles. Fertil Steril. 2011;95:293-4.