Effect of class III and class IV obesity on oocyte retrieval complications and outcomes

Phillip A. Romanski, Leslie V. Farland, Lawrence C. Tsen, Elizabeth S. Ginsburg, Erin I. Lewis

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: To assess the effect of class III (body mass index [BMI] 40–49.9 kg/m 2 ) and class IV obesity (BMI ≥ 50 kg/m 2 ) on oocyte retrieval complications and outcomes. Design: Cohort study. Setting: Academic center. Patient(s): Women who underwent an oocyte retrieval from January 1, 2012 to May 31, 2017. Women with BMI ≥ 40 kg/m 2 (n = 144) were age-matched to women with BMI <25, 25–29.9, 30–34.9, and 35–39.9 kg/m 2 (n = 1,016). Intervention(s): None. Main Outcome Measure(s): Anesthetic and procedural outcomes during oocyte retrieval. Result(s): Overall, 1,924 of 1,947 oocyte retrievals (98.8%) were performed under total intravenous anesthesia. No patients with BMI ≥ 40 kg/m 2 required intraoperative conversion to endotracheal intubation or hospital admission. Two patients (0.8%) with BMI ≥ 40 kg/m 2 required a laryngeal mask airway intraoperatively owing to oxygen desaturation. An oral/nasal airway was used to resolve oxygen desaturation in 16 patients (6.25%) with BMI ≥ 40 kg/m 2 , compared with in 17 patients (1.0%) with BMI < 40 kg/m 2 . As BMI increased, a statistically significant increase in propofol dose, fentanyl dose, and procedure time was observed. Eighteen patients (7.0%) with BMI ≥ 40 kg/m 2 underwent a transabdominal retrieval, compared with 15 (0.9%) with BMI < 40 kg/m 2 . Conclusion(s): Serious intraoperative and postoperative complications were uncommon across all BMI groups, though minor complications were more common with class III and class IV obesity. These patients were also more likely to require higher doses of propofol and fentanyl, have longer oocyte retrievals, and require a transabdominal retrieval. Overall, oocyte retrieval can be safely performed as an outpatient procedure in women with class III and class IV obesity.

Original languageEnglish (US)
Pages (from-to)294-301.e1
JournalFertility and Sterility
Volume111
Issue number2
DOIs
StatePublished - Feb 2019
Externally publishedYes

Fingerprint

Oocyte Retrieval
Fertilization in Vitro
Body Mass Index
Obesity
Fentanyl
Propofol
Oxygen
Intravenous Anesthesia
Laryngeal Masks
Intratracheal Intubation
Intraoperative Complications
Nose
Anesthetics
Cohort Studies

Keywords

  • Body mass index
  • complications
  • in vitro fertilization
  • obesity
  • oocyte retrieval

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Effect of class III and class IV obesity on oocyte retrieval complications and outcomes. / Romanski, Phillip A.; Farland, Leslie V.; Tsen, Lawrence C.; Ginsburg, Elizabeth S.; Lewis, Erin I.

In: Fertility and Sterility, Vol. 111, No. 2, 02.2019, p. 294-301.e1.

Research output: Contribution to journalArticle

Romanski, Phillip A. ; Farland, Leslie V. ; Tsen, Lawrence C. ; Ginsburg, Elizabeth S. ; Lewis, Erin I. / Effect of class III and class IV obesity on oocyte retrieval complications and outcomes. In: Fertility and Sterility. 2019 ; Vol. 111, No. 2. pp. 294-301.e1.
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abstract = "Objective: To assess the effect of class III (body mass index [BMI] 40–49.9 kg/m 2 ) and class IV obesity (BMI ≥ 50 kg/m 2 ) on oocyte retrieval complications and outcomes. Design: Cohort study. Setting: Academic center. Patient(s): Women who underwent an oocyte retrieval from January 1, 2012 to May 31, 2017. Women with BMI ≥ 40 kg/m 2 (n = 144) were age-matched to women with BMI <25, 25–29.9, 30–34.9, and 35–39.9 kg/m 2 (n = 1,016). Intervention(s): None. Main Outcome Measure(s): Anesthetic and procedural outcomes during oocyte retrieval. Result(s): Overall, 1,924 of 1,947 oocyte retrievals (98.8{\%}) were performed under total intravenous anesthesia. No patients with BMI ≥ 40 kg/m 2 required intraoperative conversion to endotracheal intubation or hospital admission. Two patients (0.8{\%}) with BMI ≥ 40 kg/m 2 required a laryngeal mask airway intraoperatively owing to oxygen desaturation. An oral/nasal airway was used to resolve oxygen desaturation in 16 patients (6.25{\%}) with BMI ≥ 40 kg/m 2 , compared with in 17 patients (1.0{\%}) with BMI < 40 kg/m 2 . As BMI increased, a statistically significant increase in propofol dose, fentanyl dose, and procedure time was observed. Eighteen patients (7.0{\%}) with BMI ≥ 40 kg/m 2 underwent a transabdominal retrieval, compared with 15 (0.9{\%}) with BMI < 40 kg/m 2 . Conclusion(s): Serious intraoperative and postoperative complications were uncommon across all BMI groups, though minor complications were more common with class III and class IV obesity. These patients were also more likely to require higher doses of propofol and fentanyl, have longer oocyte retrievals, and require a transabdominal retrieval. Overall, oocyte retrieval can be safely performed as an outpatient procedure in women with class III and class IV obesity.",
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N2 - Objective: To assess the effect of class III (body mass index [BMI] 40–49.9 kg/m 2 ) and class IV obesity (BMI ≥ 50 kg/m 2 ) on oocyte retrieval complications and outcomes. Design: Cohort study. Setting: Academic center. Patient(s): Women who underwent an oocyte retrieval from January 1, 2012 to May 31, 2017. Women with BMI ≥ 40 kg/m 2 (n = 144) were age-matched to women with BMI <25, 25–29.9, 30–34.9, and 35–39.9 kg/m 2 (n = 1,016). Intervention(s): None. Main Outcome Measure(s): Anesthetic and procedural outcomes during oocyte retrieval. Result(s): Overall, 1,924 of 1,947 oocyte retrievals (98.8%) were performed under total intravenous anesthesia. No patients with BMI ≥ 40 kg/m 2 required intraoperative conversion to endotracheal intubation or hospital admission. Two patients (0.8%) with BMI ≥ 40 kg/m 2 required a laryngeal mask airway intraoperatively owing to oxygen desaturation. An oral/nasal airway was used to resolve oxygen desaturation in 16 patients (6.25%) with BMI ≥ 40 kg/m 2 , compared with in 17 patients (1.0%) with BMI < 40 kg/m 2 . As BMI increased, a statistically significant increase in propofol dose, fentanyl dose, and procedure time was observed. Eighteen patients (7.0%) with BMI ≥ 40 kg/m 2 underwent a transabdominal retrieval, compared with 15 (0.9%) with BMI < 40 kg/m 2 . Conclusion(s): Serious intraoperative and postoperative complications were uncommon across all BMI groups, though minor complications were more common with class III and class IV obesity. These patients were also more likely to require higher doses of propofol and fentanyl, have longer oocyte retrievals, and require a transabdominal retrieval. Overall, oocyte retrieval can be safely performed as an outpatient procedure in women with class III and class IV obesity.

AB - Objective: To assess the effect of class III (body mass index [BMI] 40–49.9 kg/m 2 ) and class IV obesity (BMI ≥ 50 kg/m 2 ) on oocyte retrieval complications and outcomes. Design: Cohort study. Setting: Academic center. Patient(s): Women who underwent an oocyte retrieval from January 1, 2012 to May 31, 2017. Women with BMI ≥ 40 kg/m 2 (n = 144) were age-matched to women with BMI <25, 25–29.9, 30–34.9, and 35–39.9 kg/m 2 (n = 1,016). Intervention(s): None. Main Outcome Measure(s): Anesthetic and procedural outcomes during oocyte retrieval. Result(s): Overall, 1,924 of 1,947 oocyte retrievals (98.8%) were performed under total intravenous anesthesia. No patients with BMI ≥ 40 kg/m 2 required intraoperative conversion to endotracheal intubation or hospital admission. Two patients (0.8%) with BMI ≥ 40 kg/m 2 required a laryngeal mask airway intraoperatively owing to oxygen desaturation. An oral/nasal airway was used to resolve oxygen desaturation in 16 patients (6.25%) with BMI ≥ 40 kg/m 2 , compared with in 17 patients (1.0%) with BMI < 40 kg/m 2 . As BMI increased, a statistically significant increase in propofol dose, fentanyl dose, and procedure time was observed. Eighteen patients (7.0%) with BMI ≥ 40 kg/m 2 underwent a transabdominal retrieval, compared with 15 (0.9%) with BMI < 40 kg/m 2 . Conclusion(s): Serious intraoperative and postoperative complications were uncommon across all BMI groups, though minor complications were more common with class III and class IV obesity. These patients were also more likely to require higher doses of propofol and fentanyl, have longer oocyte retrievals, and require a transabdominal retrieval. Overall, oocyte retrieval can be safely performed as an outpatient procedure in women with class III and class IV obesity.

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