Risk of Adhesions Following Egg Retrieval Surgery
Egg retrieval (oocyte aspiration) is a minimally invasive, ultrasound-guided transvaginal procedure that carries an extremely low risk of adhesion formation, fundamentally different from the intraperitoneal surgeries discussed in adhesion literature.
Why Egg Retrieval Has Minimal Adhesion Risk
The procedure does not involve entering the peritoneal cavity in the traditional surgical sense:
No peritoneal manipulation: Egg retrieval uses a transvaginal ultrasound-guided needle to aspirate follicles directly through the vaginal wall, avoiding the extensive peritoneal handling that causes adhesions 1
No tissue trauma or ischemia: The primary mechanisms of adhesion formation—tissue trauma, ischemia, thermal injury, and foreign body presence—are essentially absent in this procedure 2, 3
Not classified as high-risk surgery: Adhesion risk is highest following colorectal, oncologic gynecological, or pediatric surgery, with 10% developing small bowel obstruction within 3 years after colectomy 1. Egg retrieval does not fall into these high-risk categories.
Context: What Actually Causes Adhesions
Adhesions form when peritoneal injury impairs fibrinolysis of fibrin deposits:
Surgical trauma requirements: Adhesions require significant peritoneal injury with tissue handling, packing, crushing, and manipulation 4, 3
Incidence in gynecologic surgery: Postoperative adhesions occur in 60-90% of patients undergoing major gynecologic surgery, with intestinal obstruction rates of 0.3% for benign procedures without hysterectomy, 2-3% with hysterectomy, and 5% with radical hysterectomy 3
Laparoscopic advantage: Even laparoscopic gynecologic procedures (which do enter the peritoneum) show reoperation rates for adhesive small bowel obstruction of only 1.4% versus 3.8% for open surgery 1
Clinical Bottom Line
Egg retrieval should not be counseled as carrying meaningful adhesion risk. The procedure's transvaginal, ultrasound-guided approach bypasses the peritoneal manipulation that drives adhesion formation. While informed consent should mention theoretical risks, adhesions are not a clinically relevant complication of this procedure based on its technical characteristics and the known pathophysiology of adhesion formation 5, 4.
If a patient has concerns about future fertility or pelvic surgery, focus counseling on the actual risks of egg retrieval (bleeding, infection, ovarian hyperstimulation) rather than adhesions, which are complications of intraperitoneal surgical procedures 3.