Background: Abnormal oocyte morphology has been associated with the hormonal environment to which the gametes are exposed. In this study, we evaluated the oocytes morphology, fertilization rate, embryos quality, and implantation rate resulted of retrieved oocytes in different times after human chorionic gonadotrophin (hCG) administration.Materials and Methods: A total of 985 metaphase II were retrieved 35, 36, 37 and 38 hours after the injection of hCG (groups 1-4 respectively). Oocyte morphology was divided into 1. normal oocytes, 2. oocytes with extracytoplasmic abnormalities (large perivitelline space and dark zona), 3. oocytes with cytoplasmic abnormalities (dark cytoplasm, granular cytoplasm and aggregates of smooth endoplasmic reticulum) and 4. intracytoplasmic vacuoles.Results: Extracytoplasmic abnormalities were encountered in 17.76% and 31.1% of these oocytes (groups 3 and 4 respectively, p<0.001) in comparison with 12.23% (group 2). Intracytoplasmic vacuoles rate were 10.52% and 3.12% (group 4 versus group 2, p<0.01). Cytoplasmic abnormalities differed between the group 4 and other groups.23.88% (p<0.01) and 43.25% (p<0.001) of resulted 2PN (two pronucleus) from groups 3 and 4 showed grade Z3 respectively in comparison to group 2 (16.44%). Normal and various categories of abnormal oocytes did not differ regarding fertilization and cleavage rates (p>0.05). However, group 4 showed significantly difference in the rate of embryos fragmentation (grade 3 and 4 embryo) in comparison with group 2 (40.96% versus 24.93%, p<0.01). The pregnancy rate was influenced but the implantation rate did not differ.Conclusion: Furthermore, oocyte retrieval time following hCG priming affected on oocyte morphology, 2PN pattern and embryos qualities subsequently.

Background: Pelvic inflammatory disease with progression to pelvic abscess is a rare complication after oocyte retrieval during in vitro fertilization cycles. However, in patients with endometriosis the risk appears to be increased. Many authors agree on the need for antibiotic prophylaxis during the oocyte retrieval in these patients, but there is no consensus regarding the best antibiotic.Case: We discuss 3 clinical cases of tubo-ovarian abscess in women with endometriosis after oocyte retrieval despite antibiotic prophylaxis between 2004 and 2011 at our center, and discuss our experience in the context of earlier reports.Conclusion: It is unclear whether antibiotic prophylaxis is necessary in these women, and which antibiotic is best. Only douching with povidone-iodine appears to decrease the rate of pelvic infection.

Inhaled anesthetics may produce adverse effects on the rate of oocyte fertilization and pregnancy. Therefore, these drugs are preferably not used in general anesthesia for egg retrieval and often intravenous anesthetics are used instead. In this study, midazolam - fentanyl was used and according to hemodynamic responses to surgical stimulations, depth of anesthesia was determined. 120 healthy infertile women scheduled for egg retrieval. They were divided into two groups. The case group recieved 0.07 mg/kg midazolam + 1.5 mcg/kg fentanyl + 2 mg/kg thiopental for the induction of anesthesia. These patients were compared with the control group, who recieved 4 mg/kg thiopental + 1.5 mcg/kg fentanyl for induction of anesthesia. In both groups, maintenance of anesthesia was with incremental doses 50 mg of thiopental. Blood pressure and pulse rate before and during the anesthesia was determined in all patients. Also, depth of anesthesia was evaluated accordingly. In addition, recovery time and respiratory depression during recovery was determined for all the patients. 85% of the patients in case group had deep anesthesia during surgery. Comparing with control group, midazolam was associated with a significant higher incidence of "deep" anesthesia. Also, the case group recieved 1 mg/kg thiopental as incremental doses during anesthesia while controls recieved 2 mg/kg. The aforementioned result also indicates that depth of anesthesia in case group is deeper than the controls. The recovery time in case group was more prolonged than the other group, p-value = 0.002. Also, 33.3% of patients in case group had respiratory depression in recovery time. These patients recieved flumazenil. In conclusion, midazolam administration for induction of anesthesia may produce a "deep anesthesia" in procedure of egg retrieval. However, midazolam can significantly prolong the recovery time and causes respiratory depression. These side effects can be reversed by flumazenil.

Severe pelvic infections following ultrasound-guided transvaginal oocyte retrieval (TVOR) are rare but challenging. Ovarian abscess formation is one of the consequences and management of such cases as highly debated in pregnant patients. In this case report, an early fetal loss following laparoscopic management of ovarian abscess is described and possible etiologies are discussed.

Pelvic inflammatory disease (PID) is a rare complication of transvaginal oocyte retrieval. It may result in failure of assisted reproductive techniques (ART). During a 7 years period, 5958 transvaginal ultrasound-guided oocyte retrievals resulted in 10 cases of acute PID. Eight out of 10 patients were diagnosed infertile because of endometriosis. Two patients had mild ovarian, 3 had stage III, and 2 had stage IV endometriosis. One patient had a 3-4 cm ovarian endometrioma. After treatment, no mortality was encountered among the 10 patients, although none of them conceived. This observation supports the previous reports that endometriosis can raise the risk of PID after oocyte retrieval. More vigorous antibiotic prophylaxis and better vaginal preparation are recommended when oocyte pickup is performed in patients with endometriosis.

Background: Abnormal oocyte morphology has been associated with the hormonal environment to which the gametes are exposed. Objective: In this study, we evaluated the oocytes morphology, fertilization rate, embryos quality, and implantation rate resulted of retrieved oocytes in different times after human chorionic gonadotrophin (HCG) administration.Materials and Methods: A total of 985 metaphase II oocytes were retrieved 35, 36, 37 and 38 h after the injection of HCG as groups 1, 2, 3, and 4 respectively. Oocyte morphology was divided into (I) normal morphology, (II) extracytoplasmic abnormalities, (III) cytoplasmic abnormalities and (IV) intracytoplasmic vacuoles and in each group, oocytes were evaluated according to this classification.Results: Extracytoplasmic abnormalities were encountered in 17.76% and 31.1% of these oocytes (groups 3 and 4 respectively, p=0.007) in comparison with 12.23% group 2. Cytoplasmic abnormalities in group 4 were higher than other groups. 23.88% (p=0.039) and 43.25% (p=0.089) of resulted 2PN (two pronucleus) from groups 3 and 4 showed grade Z3 respectively in comparison to group 2 (16.44%). Normal and various categories of abnormal oocytes did not differ regarding fertilization and cleavage rates (p=0.061). However, group 4 showed significant difference in the rate of embryos fragmentation (grade III and IV embryo) in comparison with group 2 (40.96% vs. 24.93%, p=0.078). The pregnancy rate was higher in G2 and G3 groups (28.5 and 24.13% respectively).Conclusion: Oocyte retrieval time following HCG priming affected on oocyte morphology, 2PN pattern and embryos qualities subsequently. Both good quality embryo formation and pregnancy outcomes were noticeably higher when oocytes were retrieved 36 h after HCG priming in ART program.

Background: Many women experience oocyte retrieval during an IVF treatment as a stressful and emotionally difficult situation. Women fear the pain as associated with oocyte retrieval. Based on the existing literature, a coping intervention for oocyte retrieval (CIFOR) was developed to deal with the stress and pain during oocyte retrieval. The objective of this study was to explore the experiences of women using coping intervention for oocyte retrieval (CIFOR) while undergoing oocyte retrieval. Methods: For this generic qualitative study, a purposeful sample of fifteen women was gathered from a university clinic in the Netherlands and each participant was interviewed. Background information about the IVF treatment was collected from medical files. Semi-structured interviews were performed approximately 15 min after the OR procedure. Data were analyzed using the Qualitative Analysis Guide of Leuven and processed using MAXQDA. Results: Twenty-five women were approached for this study between January and May 2018. This study identified five themes that were important in the experiences of women using CIFOR: highly valuing the CIFOR, feasible in daily practice, need for information, sense of control and partner’ s involvement. Conclusion: Women highly valued the tool. They found CIFOR feasible in daily practice and it fulfilled their needs for information. In addition, women had a sense of control using the intervention. Future research will involve performing a pilot study according to the Medical Research Council framework with outcomes based on the patient’ s sense of control, ability to cope, coping strategies, anxiety and pain.