title: Minimizing the Risk of Infection and Bleeding at Trans-Vaginal Ultrasound-Guided Ovum Pick-up: Results of a Prospective Web-Based World-Wide Survey.
abstract: OBJECTIVE
  The objective of this study was to identify clinical practices worldwide, which would help in recognizing women at risk of excessive bleeding or of developing pelvic infection following trans-vaginal ovum pick-up (TV-OPU), measures taken to minimize risks and their management.
  
  
  METHODS
  A prospective, web-based questionnaire with distinct questions related to the practice of TV-OPU.
  
  
  RESULTS
  A total of 155 units from 55 countries performing 97,200 IVF cycles annually responded to this web-based survey. A majority (65 %) responded that they would routinely carry out full blood count, while 35 % performed coagulation profile. Less than a third agreed screening women for vaginal infections. About a third used both sterile water and antiseptic to minimize ascending infection, and 52 % used antibiotics for prophylaxis. Doppler ultrasound was routinely used by 20 % of clinicians. 73 % of the clinicians preferred conservative management as their first line management for patients diagnosed with intra-abdominal bleeding.
  
  
  CONCLUSIONS
  The study has identified a wide variation in the practices of minimizing infection and bleeding complications. The dearth of good quality evidence may be responsible for the lack of published guidelines, and therefore a lack of consensus on the optimum practice for minimizing the risk of infection and bleeding during TV-OPU.
authors.affiliation: Centre for Reproductive Medicine, University Hospitals of Coventry and Warwickshire NHS Trust, Coventry, Warwickshire CV2 2DX UK ; The University of Warwick, Coventry, Warwickshire UK.
authors.forename: Harish
authors.initials: H
authors.lastname: Bhandari
authors.affiliation: Centre for Reproductive Medicine, University Hospitals of Coventry and Warwickshire NHS Trust, Coventry, Warwickshire CV2 2DX UK ; The University of Warwick, Coventry, Warwickshire UK.
authors.forename: Rina
authors.initials: R
authors.lastname: Agrawal
authors.affiliation: IVF Unit, Department of Obstetrics and Gynaecology, Edith Wolfson Medical Center, Holon, Israel ; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ariel
authors.initials: A
authors.lastname: Weissman
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Gon
authors.initials: G
authors.lastname: Shoham
authors.affiliation: IVF Center, The Hong Kong Sanatorium and Hospital, Happy Valley, Hong Kong, China.
authors.forename: Milton
authors.initials: M
authors.lastname: Leong
authors.affiliation: The Reproductive Medicine Unit, Kaplan Medicine Center, Rehovot, Israel ; Hadassah Medical School, Affiliated to the Hebrew University, Jerusalem, Israel.
authors.forename: Zeev
authors.initials: Z
authors.lastname: Shoham
keywords: Bleeding; Complications; In-vitro fertilization; Infection; Ovum pick-up