臨床婦人科産科75巻7号

2021年07月発行

今月の臨床 専攻医必携！ 術中・術後トラブル対処法―予期せぬ合併症で慌てないために 生殖編

採卵

著者： 片桐由起子¹² 福田雄介¹²

所属機関： ¹東邦大学医学部産科婦人科学講座 ²東邦大学医療センター大森病院リプロダクションセンター

ページ範囲：P.648 - P.653

●採卵前には，骨盤腔内を観察し，子宮内膜症の併存や骨盤内炎症の既往など感染のハイリスク症例では，個別のリスク説明を実施しておく．

●採卵では，卵胞と超音波プローブの間の臓器介在を回避し，腟壁および卵巣表面の穿刺回数が最小限になるように心がける．

●採卵後には，全身状態を観察し，離院前に再度超音波による診察を行い，排尿状態を確認してから離院を認めることが望ましい．

参考文献

1）日本生殖医学会（編）：生殖医療の必修知識2020．杏林社，2020

2）Levi-Setti PE, et al : Appraisal of clinical complications after 23,827 oocyte retrievals in a large assisted reproductive technology program. Fertil Steril 109 : 1038-1043, 2018

3）Özaltın S, et al : Evaluation of complications developing during and after transvaginal ultrasound - guided oocyte retrieval. Ginekol Pol 89 : 1-6, 2018

4）Siristatidis C, et al : Clinical complications after transvaginal oocyte retrieval : a retrospective analysis. J Obstet Gynaecol 33 : 64-66, 2013

5）ESHRE Working Group on Ultrasound in ART ; D'Angelo A, et al : Recommendations for good practice in ultrasound : oocyte pick up. Hum Reprod Open 2019 : hoz025, 2019

6）Ludwing AK, et al : Preioperative an post-operative complications of transvaginal ultrasound-guided oocyte retrieval : prospective study of＞1000 oocyte retrievals. Hum Reprod 21 : 3235-3240, 2006

7）Nouri K, et al : Severe haematoperitoneum caused by ovarian bleeding after transvaginal oocyte retrieval : a retrospective analysis and systematic literature review. Reprod Biomed Online 29 : 699-707, 2014

8）Siristatidis C, et al : Clinical complications after transvaginal oocyte retrieval : a retrospective analysis. J Obstet Gynaecol 33 : 64-66, 2013

9）Tureck RW, et al : Perioperative complications arising after transvaginal oocyte retrieval. Obstet Gynecol 81 : 590-593, 1993

10）Benaglia L, et al : Oocyte retrieval difficulties in women with ovarian endometriomas. Reprod Biomed Online 37 : 77-84, 2018

11）Kelada E, et al : Bilateral ovarian abscess following transvaginal oocyte retrieval for IVF : a case report and review of literature. J Assist Reprod Genet 24 : 143-145, 2007

12）Villette C, et al : Risks of tubo-ovarian abscess in cases of endometrioma and assisted reproductive technologies are both under- and overreported. Fertil Steril 106 : 410-415, 2016