The incidence of major clinical complications in a Dutch transport IVF programme

Four different major clinical complications were identifiedin a retrospective analysis of 2495 in-vitro fertilization (IVF)cycles resulting in oocyte retrieval. The severe form of ovarianhyperstimulation syndrome (OHSS) occurred in 18 patients, givinga prevalence for this complication of 0.7%. Seven (39%) of these18 patients had previously been diagnosed as having polycysticovaries. Eleven patients were admitted with moderate OHSS. Adnexaltorsion was diagnosed in two patients. Ovariectomy was considerednecessary in both cases. Complications of the transvaginal procedureoccurred in seven cases (0.3%): one patient had an acute appendicitiswith puncture holes in the appendix, six patients were admittedshortly after oocyte retrieval with a pelvic inflammatory disease.Of the 624 pregnancies obtained, 13 were ectopic, giving anectopic pregnancy rate of 2.1%. It is concluded that seriousclinical complications of IVF treatment are rare. However, patientsshould be counselled for the occurrence of serious procedure-relatedcomplications before entering an IVF programme.