title: Pneumoperitoneum induced pH changes in follicular and Douglas fluids during laparoscopic oocyte retrieval in humans.
abstract: The effects of different insufflation media gases for pneumoperitoneum on the acidity of follicular fluid and blood acid--base balance were studied in two groups of patients during laparoscopic oocyte retrieval. Insufflation with 100% CO2 was compared with insufflation with 5% CO2 in air. End-tidal CO2 and the acid-base status of arterial blood, follicular and Douglas fluids were evaluated. When using 5% CO2 in air as insufflation gas, pH values and pCO2 levels observed in the aspirated follicular (pH: 7.35 +/- 0.06, pCO2: 38.8 +/- 4.5 mmHg) and Douglas fluid (pH: 7.40 +/- 0.07, pCO2: 38.5 +/- 6.2 mmHg) remained normal. With 100% CO2 insufflation, the follicular fluid pH (7.22 +/- 0.07) and pCO2 (53.1 +/- 10.9 mmHg) and the Douglas fluid pH (6.99 +/- 0.12) and pCO2 (90.3 +/- 18.4 mmHg) were grossly disturbed and outside the physiological range. No differences occurred in pO2 or HCO3 levels. These data suggest that pneumoperitoneum with 5% CO2 in air provides more optimal environmental conditions for oocytes used for in-vitro fertilization. However, further investigations on large patient groups are required to demonstrate whether such environmental conditions influence the success rate of in-vitro fertilization in humans.
authors.affiliation: Department of Anaesthesiology, University of Brussels, (VUB), Belgium.
authors.forename: D
authors.initials: D
authors.lastname: Verbessem
authors.forename: F
authors.initials: F
authors.lastname: Camu
authors.forename: P
authors.initials: P
authors.lastname: Devroey
authors.forename: A
authors.initials: A
authors.lastname: Van Steirteghem
mesh_terms: D000136:Acid-Base Equilibrium; D000328:Adult; D001639:Bicarbonates / Q000032:analysis / Q000097:blood; D002245:Carbon Dioxide / Q000032:analysis / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D006863:Hydrogen-Ion Concentration; D010535:Laparoscopy; D009865:Oocytes / Q000166:cytology*; D006080:Ovarian Follicle / Q000502:physiology*; D010100:Oxygen / Q000032:analysis / Q000097:blood; D010313:Partial Pressure
chemical_list: D001639:Bicarbonates; D002245:Carbon Dioxide; D010100:Oxygen