Complications of transvaginal ultrasound-directed follicle aspiration: A review of 2670 consecutive procedures

Abstract

The low incidence of pelvic infection questions the value of using prophylactic antibiotics. No increased risk of infection was demonstrated in cases with preexisting peritoneal damage.

Endometriosis may contribute to oocyte retrieval-induced pelvic inflammatory disease: report of eight cases{1}

“…This paper reports 10 cases of PID following oocyte pickup with the suggestion of endometriosis as a potential risk factor. Inoculation of vaginal bacteria and anaerobe opportunists is suggested to be the cause of PID following oocyte retrieval (Bennett et al, 1993). Microorganisms of vagina are suggested to be the etiological pathogens in pelvic abscesses when transvaginal oocyte retrieval is used (Bennett et al, 1993).…”

Minimizing the Risk of Infection and Bleeding at Trans-Vaginal Ultrasound-Guided Ovum Pick-up: Results of a Prospective Web-Based World-Wide Survey

“…Egbase et al [23] reported that prophylactic antibiotics at TV-OPU, not only reduced the number of microbiology positive embryo catheter tips 48 h after the procedure, but also significantly increased implantation and clinical pregnancy rates. The pelvic infection rate was between 0.4 and 0.6 % in some studies where routine antibiotics prophylaxis was not administered [4,6]. Prophylaxis has been strongly advocated by some authors [24], but substantial evidence for its usefulness seems to be lacking.…”

“…Though Serour et al [16] recommend the routine use of color Doppler at TV-OPU, Risquez and Confino [17] advice that the identification of smaller blood vessels on ultrasound Doppler may not entirely remove the risk of moderate to severe bleeding. Shalev et al [15] recommend the use of a pelvic ultrasound scan before discharging the women from the unit to Iatrogenic pelvic infection following TV-OPU can occur as a result of ascending infection (follicular aspiration needle carrying micro-organisms from the vagina into the pelvis), by the reactivation of a dormant infection (from a previous PID) or very unlikely, from fecal peritonitis secondary to bowel injury [6]. Pelvic infections occur within a few days to couple of weeks' of the procedure, but delayed pelvic infection in early pregnancy and in late pregnancy has also been reported [18][19][20].…”

“…The risk of pelvic infection (0.1-0.6 %) [2] and severe intraabdominal bleeding (0.05-0.2 %) [2][3][4][5] is very low. Though severe intra-abdominal bleeding usually occurs as a result of injury to sub-capsular ovarian vessels or small intra-follicular vessels [1], injury to pelvic vessels and coagulation abnormalities can also cause hemoperitoneum and retroperitoneal bleeding [6][7][8][9].…”

Vaginal disinfection with povidone iodine immediately before oocyte retrieval is effective in preventing pelvic abscess formation without compromising the outcome of IVF-ET

“…Even with prophylactic antibiotics, the reported incidence of pelvic infection in OCR was around 0.6% (2). So far, there is no effective method of preventing this undesired complication.…”