And there are complications that are less threatening, such as difficulty in breathing, that can require the patient to be intubated.
When Dr. Approximately 8 percent of the obese patients experienced desaturation, compared with less than 1 percent of those of normal weight. And 1. The bottom line, Dr. Tsen said, is that the potential risks of anesthesia for oocyte retrieval are very low—rare mortality, rare major morbidity, and rare minor morbidity. The one potential risk factor that applies to egg donors and that might put them at more risk during anesthesia is if they are obese, but even then the potential risks remain very small.
Is her ability to have children in the future threatened in any way by having had this surgery? Nicholas Cataldo, formerly an assistant professor of obstetrics and gynecology at Stanford University, reviewed the evidence bearing on this question for the workshop.
Cataldo examined two possible pathways by which oocyte retrieval might conceivably affect future fertility. The first pathway begins with the infection and bleeding that, as described above, are occasional side effects of retrieval surgery.
These side effects sometimes lead to the need for surgery or to the formation of adhesions, the sticking-together of two adjacent tissues. Both of these results, Dr.
Cataldo said, could theoretically lead to fertility problems. There is little evidence to support this possibility, however. According to one large study, the rate of infection after oocyte retrieval was about 1 in every IVF cycles, and surgery is needed to treat pelvic abscesses in less than 1 in 1, IVF cycles.
Furthermore, since women have a set of two ovaries and two fallopian tubes, they can remain fertile even if one set is damaged, and there is no evidence that both might be threatened simultaneously by the side effects of retrieval surgery. In one study that examined this particular issue, Dr. Cataldo said, none of the women who had surgery to treat abscesses had them on both sides or lost both fallopian tubes or ovaries.
As for adhesions, research has not found a higher rate of adhesions among women who have undergone oocyte. Finally, Dr. Cataldo said, since the data involve mainly women who have had fertility problems, it can be expected that the rate of infection among egg donors will be lower than has been seen in the published studies. All of this implies that there is little potential risk of future fertility being threatened in egg donors by infection or bleeding accompanying the retrieval surgery.
The second potential pathway to fertility risk begins with the trauma applied to the ovary by having a needle thrust through its surface. It has been suggested that this trauma could lead to the development of anti-ovary antibodies, and, indeed, several studies have found that women who have undergone oocyte retrievals have a greater prevalence of antibodies to ovarian tissue than those who have not undergone the surgery.
Furthermore, antibodies to ovarian antigens have been shown to be associated with IVF failures and with women having multiple attempts at IVF—a situation that, again, implies that they have had previous failures.
Cataldo said, that somehow these antibodies may interfere with sperm binding with or penetrating the oocyte and thus make it harder to fertilize the egg, but there is no evidence that this actually happens. It is difficult to know whether antibodies formed in one IVF cycle have anything to do with the failure of subsequent IVF attempts, or even if the antibodies play any role at all in infertility. Cataldo concluded. And whatever risk there may be for women undergoing IVF, the risk would be expected to be somewhat lower in healthy women donating eggs for research.
Once hormone treatment has led the ovaries to create a large number of antral follicles ready to ovulate, a surgeon must retrieve the eggs from the follicles by putting a needle through the wall of the vagina into the ovary and using the needle to aspirate the individual follicles. This surgery must be done with anesthesia, and there are a number of health risks that accompany the surgery and the anesthesia.
The statistics on egg retrieval surgery indicate that the risks of complication are relatively low. One study of several hundred thousand surgeries found, for example, that vaginal bleeding occurred in 0. Only 0. Complications due to infection are rare as well. Although a study found 9 patients out of 1, had pelvic abscesses that needed to be treated, that seems to have been due to a failure to consistently use aseptic techniques.
A later study in which aseptic techniques were used found no abscesses that required treatment. Ovarian torsion is another rare complication in women undergoing IVF—about 0. According to Dr. Cataldo, this complication seems mainly due to the softening of the ligaments that occurs during pregnancy.
Rosenwaks added that it can also occur due to hyperstimulation, even in the absence of pregnancy. Various factors increase the risk of complications from retrieval surgery, including previous surgeries, a history of pelvic inflammatory disease, endometriosis, and pelvic adhesions. All these factors are more likely to be found in women undergoing in vitro fertilization than in the general population, which implies that egg donors should have much lower surgical risks than women undergoing IVF.
Patients undergoing egg retrieval surgery generally rely on either intravenous anesthesia or intravenous conscious sedation. In general, anesthesia is safe, with deaths occurring only once every , to , cases. Because egg donors have few of the factors that increase the risks of anesthesia, including being male, being older, being obese, having inpatient rather than outpatient surgery, having surgery in an emergency setting, and having a high ASA classification, anesthesia should be even safer for egg donors than it is for surgical patients in general.
It is widely understood that stem cell treatments have the potential to revolutionize medicine. Under the direction of the California Institute for Regenerative Medicine, this program will pay to build facilities for stem cell research and will fund doctors and scientists to carry out research with the ultimate goal of helping to develop therapies based on stem cells.
For this research to move forward, however, will require a steady supply of stem cells, particularly human embryonic stem cells. Those stem cells are collected from developing human embryos created from eggs—or oocytes—harvested from the ovaries of female donors. Thus much of the promise of stem cells depends on women choosing to donate oocytes to the research effort. The oocyte donation process is not without risk, however.
Donors are given doses of hormones to trigger the production of more eggs than would normally be produced, and this hormone treatment can have various side effects. Once the eggs have matured in the ovary, they must be retrieved via a surgical procedure that is typically performed under anesthesia, and both the surgery and the anesthesia carry their own risks. Furthermore, given the very personal nature of egg donation, the experience may carry psychological risks for some women as well.
With this in mind, in the California Institute for Regenerative Medicine contracted with the National Academies to organize a workshop that would bring together experts from various areas to speak about the potential risks of oocyte donation and to summarize what is known and what needs to be known about this topic. Log in Sign up. Home Community Getting pregnant Assisted Conception.
Ovulated before egg collection. Hi everyone I went for a scan on Friday and it showed three follicles , one more than likely a cyst ,1 a mature follicle and one small follicle. So did my trigger shot at 9.
Has anyone had this happen to them where to now? Any ideas K xxx. Omg that's horrible, so sorry Obay, that's a real disappointment. No experience sorry :. Obay Original poster. Oh my, my greatest fear. I had this happen on my very 1st cycle antagonist with Gonal F and Cetrotide, however thankfully my FS cancelled the cycle before epu.
Since then I've always done down reg agonist cycles. So sorry you were put through this! Big hugs honey.
I was on 1 injection of metaphor ml and then syneral nasal spray twice a day that was supposed to do the same thing. I think they will tell me to give up now Who knows K xxx. Oh may I add it was extremely painful as they looked around to find the illusive egg. This risk is further evidenced by reports of dizygotic twinning after single blastocyst embryo transfer see supplementary Table 1. The authors declare that there are no conflicts of interest regarding the publication of this paper.
Figure 1: Summary of case presentation. Table 1: Literature review of dizygotic twinning after single embryo transfer. Supplementary Materials.
This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Article of the Year Award: Outstanding research contributions of , as selected by our Chief Editors. Read the winning articles. Journal overview. Brindha Bavan 1 and Amin A. Academic Editor: Seung-Yup Ku.
Received 19 Mar Accepted 03 Jul Published 06 Aug Abstract In addition to the potential for multiple pregnancy, spontaneous conception during in vitro fertilization IVF can lead to undesired genetic outcomes. Case Presentation A year-old Chinese-Vietnamese nulliparous female presented to our clinic after trying to conceive for 1 year and 9 months without success.
Discussion In recent years, preimplantation genetic testing has become increasingly popular and is performed in a significant portion of IVF cycles in many clinics. Conflicts of Interest The authors declare that there are no conflicts of interest regarding the publication of this paper. Supplementary Materials Figure 1: Summary of case presentation. References A. Marcus, D. Marcus, S. Ayis, A. Johnson, and S. Vardon, C. Burban, J. Collomb, V.
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