Possible complications after egg retrieval

This is an automatically translated article.

The article is professionally consulted by MSc, BS. Nguyen Ngoc Chien, Reproductive Support Center - Vinmec Times City International General Hospital.
Egg retrieval is inherently a sophisticated technique. All operations require gentleness, if not performed correctly, there are many potential risks. Accordingly, possible complications after oocyte retrieval are things that need to be mastered and maximally prevented, in order to ensure a successful in vitro fertilization process for infertile women.

1. What is egg retrieval?

After hormone treatment to stimulate the ovaries to make more than one egg at a time, the doctors who assist in IVF will remove the mature eggs.
Egg retrieval procedure will take place about 36 hours after the injection of HCG to mature the ovum. During natural ovulation, a follicle bursts and the ovum is released. Then, the ovum is quickly sucked into the tube, through the fallopian tube towards the uterus. Therefore, egg retrieval must be precisely timed so that the eggs can be caught just before they begin this journey, at a time when they are ready to fertilize but are still in the follicle and can be easily observed. observed under ultrasound.
To collect the eggs, the doctor will insert an ultrasound probe into the vagina with a needle attached to insert the needle through the vaginal wall and into the ovary. All manipulations are guided by ultrasound. Once the needle is in the ovary, the doctor will adjust the needle to puncture the follicles one by one. When the needle is in the cyst, the suction machine will suck all the cyst fluid along the needle into the test tube. Finally, the doctor will look in the fluid taken from the follicles for egg cells (ovules).

The procedure usually lasts about 15 minutes and is done in the operating room, the patient stays in the hospital during the day. Therefore, the woman after a stable observation period will be able to go home. Even so, it's still a procedure that needs to be done under anaesthesia and the potential risks can't be denied. Accordingly, the possible complications of egg retrieval are presented in turn below.

2. Possible complications after egg aspiration

Most complications from an aspiration procedure originate from the way the needle is inserted through the vagina and into the ovary, causing damage to other nearby organs and sensitive tissues, such as the iliac arteries. inside the ovary or the ureter located right next to the ovary.
Accordingly, the patient is at risk of intra-abdominal bleeding after egg aspiration due to needle puncture in the great artery. The walls of the arteries in the abdomen and pelvis can be more susceptible to tearing with each beat, further worsening the bleeding. Blood may spread to the abdomen or into the vagina; Accordingly, sometimes emergency surgery is needed to stop bleeding and clean the abdomen. However, thanks to ultrasound guidance, the incidence of complications from this procedure is very low. Intra-abdominal bleeding immediately following oocyte retrieval can also be caused by damage to the blood vessels in or within the ovary during the procedure. This complication is less serious but occurs with greater frequency than bleeding from iliac vessel injury.

Other possible complications are intestinal trauma, peritonitis, ureteral stricture injury, pelvic abscess...
Another complication that has also been reported to occur after egg aspiration is Ovarian torsion, which occurs when the ovary twists around itself, cutting off the blood supply. In a study of 1,500 women, the incidence of ovarian torsion occurred in 0.13% of cycles. Unfortunately, however, ovarian torsion usually occurs as late as 6 to 13 weeks after oocyte retrieval. At the same time, because this is also a complication that can also be seen in a normal pregnancy, this complication occurs with a greater frequency in IVF because the two ovaries are enlarged after ovulation, so it is easier to twist.
In order to avoid the above complications, the operations performed will require the highest level of accuracy. This is especially important in high-risk subjects such as previous abdominal surgery, a history of pelvic inflammatory disease or even ovarian endometriosis.

3. Complications from anesthesia/anesthesia

Besides the potential risks associated with the procedure, women who undergo egg retrieval also face certain potential risks from the anesthesia used to control pain. during execution.
Accordingly, the pain caused by egg retrieval is caused by the force of pushing the needle through the vaginal wall and inserting the needle into the ovary. Because these pain signals travel back to the spinal cord before reaching the brain, the patient may consider taking an anesthetic commonly used during childbirth. These are injections that numb the spinal cord, inhibiting nerve conduction on either side of the cervix to block pain. If a spinal anesthetic cannot be used, the patient may need intravenous medication to induce anesthesia. At this time, the patient will be at risk when using anesthesia similar to patients in other common surgery such as allergy to anesthetic, hypotension, prolonged respiratory depression... Currently, almost all patients are at risk. All patients with egg aspiration are relieved by intravenous anesthesia due to the simplicity and low complications of this procedure.

4. Long-term complications on reproductive function

There are two possible reasons for possible post-aspiration risks that could affect future fertility. The primary reasons start with complications of infection and bleeding, as described above, and sometimes surgery is needed to manage the damage, which can have long-term effects on fertility. .
The second reason is damage to the organs of the reproductive system when the needle penetrates the surface, going from the vagina to the ovary. It has been hypothesized that these traumas may lead to the formation of antibodies against the ovaries, and indeed, some studies have found that women after oocyte retrieval will have a higher percentage of antibodies to ovarian tissue than those who do not undergo this procedure.
Furthermore, antibodies to ovarian antigens have been shown to be associated with IVF failure. Because antibodies will interfere with the binding of sperm when entering the egg cell and thus will make it more difficult to fertilize the egg. Fortunately, this event is very rare.

In summary, the procedure of aspiration from the follicle by inserting a needle through the vaginal wall into the ovary, which needs to be performed under anesthesia, is difficult to avoid certain complications. Statistics show that the risk of complications is relatively low. Therefore, choosing a reputable and highly specialized fertility support center is extremely necessary, in order to absolutely minimize the risk of complications, which is the first basic step in the journey to finding a smile. child.
Master doctor. Nguyen Ngoc Chien has been trained as well as certified by many famous medical universities in the country and the world. With many years of experience in the field of obstetrics and gynecology, she is currently working at the Reproductive Center of Vinmec Times City International Hospital.

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