Blood loss during transvaginal oocyte retrieval.

BACKGROUND/AIMS: Limited information is available regarding the quantity of blood loss associated with uncomplicated transvaginal oocyte retrieval. The aim of the present study was evaluating the quantity of such a loss. METHODS: One hundred and fifty consecutive women undergoing oocyte retrieval were recruited. They underwent blood test assessment and ultrasonographic transvaginal evaluation at three different times: (1) immediately before initiating oocyte retrieval, (2) 4-6 h later, and (3) 72 h later. RESULTS: At 4-6 h after oocyte retrieval, the red blood cell count and the hemoglobin concentration were significantly reduced, whereas pelvic free fluid had significantly increased. The estimated median (Interquartile range) blood loss was 72 (-8/162) ml. None of the recruited women was found to have a hemoglobin reduction >2 g/day or an increase in the pelvic free fluid >200 ml or a calculated blood loss >500 ml (0.0%, 95% CI: 0.0-2.4%). No significant worsening from baseline was observed at the 72 h evaluation. CONCLUSIONS: The quantity of blood loss following oocyte retrieval is clinically unremarkable in the vast majority of women.

The presence of ovarian endometriomas is associated with a reduced responsiveness to gonadotropins.

OBJECTIVE: To clarify whether the presence of ovarian endometriomas is associated with a reduced responsiveness to ovarian hyperstimulation. DESIGN: Observational study. SETTING: University teaching hospital. PATIENT(S): Women selected for in vitro fertilization-intracytoplasmic sperm injection (IVF-ICSI) cycles who were found to have unilateral ovarian endometriomas and who did not undergo previous ovarian surgery. INTERVENTION(S): Ovarian hyperstimulation using gonadotropins. MAIN OUTCOME MEASURE(S): Number of codominant follicles (mean diameter >15 mm) in the affected and in the contralateral intact gonads. RESULT(S): Thirty-six patients were enrolled. They underwent 56 IVF-ICSI cycles. The number of codominant follicles in the intact and affected ovaries were 4.0 +/- 2.2 and 3.0 +/- 1.7, respectively (P=.01). This difference corresponded to a mean reduction (95% confidence interval [CI]) of 25% (6%-44%). This deleterious effect was more evident in women with larger cysts, in those with more than one cyst, and in those who were more responsive to ovarian hyperstimulation. CONCLUSION(S): The presence of ovarian endometriomas is associated with a reduced responsiveness to gonadotropins.