An Endometriosis Patient Presented with Gross Hematuria as a Complication of the Oocyte Pick-Up Procedure

Abstract

of urinary tract injuries are sometimes seen (4, 5). However, it should be kept in mind in case of endometriosis and in adhesions secondary to infections (6). As in our case, more vaginal needle punctures can be required in endometriosis patients. Thus, we should be aware of possible injuries of adjacent organs, such as the bladder. Case Our patient was a 34-year-old female. She had primary infertility for six years. The etiology explained this condition as endometriosis. She had an endometrioma cyst excision history from the right side and poor ovarian reserve. The parameters of male factor were in normal range. Because of the poor ovarian reserve problem, she was enrolled for the in vitro fertilization program accordingly. The evaluation was carried out through physical examination and ultrasonography before her treatment. Her baseline total antral follicle count (AFC) was seven and her right ovary was found adherent to the posterior uterine wall. The size of the uterus was found to be normal, but it was adenomyotic. The hormonal assays were also carried out. Antagonist protocol was started with 375 IU dose of recombinant follicle-stimulating hormone (FSH) on the second day of menstrual cycle. The antagonist was added on the seventh day and the stimulation was continued until the eleventh day. Afterwards, the recombinant human chorionic gonadotropin (hCG) was applied when the level of serum E2 was 705 and the leading follicle was 19 mm. The oocyte retrieval was performed vaginally by transvaginal ultra-sonographic guidance with empty bladder after

Does the presence of endometriosis cause a challenge for transvaginal oocyte retrieval? A comparison between patients with and without endometriosis

“…Pelvic adhesions due to endometriosis or infections are suggested to increase the risk of such injuries secondary to distorted anatomy. Although unproven, practically, it can be recommended to maintain the needle guidance in a lateral position during punctures, away from the anterior structures ( 21 , 22 ).…”