By See author list at the end of this article
Tables: The authors
Transvaginal ultrasound-guided follicle aspiration (TVA) is being performed commonly in clinical equine practice. There is limited information in the literature about the type and incidence of complications related to TVA. We conducted a survey, completed by 23 practicing veterinarians, soliciting information about the types and incidence of minor and major complications and of fatalities they had experienced associated with performance of TVA.
1. Introduction
Embryo production via intracytoplasmic sperm injection (ICSI) has grown in popularity as a reproductive management tool in horses. As a result, transvaginal ultrasound-guided follicle aspiration (TVA) is being performed on increasing numbers of mares, including young, fertile mares, to recover oocytes for ICSI. During TVA, a needle is introduced through the vaginal wall into the peritoneum, and the ovary is punctured repeatedly under ultrasonographic guidance, presenting the opportunity for both infectious and traumatic complications. Limited information is available in the literature on the incidence and type of complications associated with performance of TVA. This information is vital to inform discussions with mare owners on the decision to use ICSI to produce embryos from their mare.
We previously evaluated effects of repeated TVA on ovarian status and on findings on abdominocentesis in a herd of research mares [1]. From that study, we concluded that major complications of this procedure are rare, occurring in about 1 in 300 aspirations. Rodriguez and coworkers [2] reported no complications after performance of TVA on 66 mares, by 22 veterinarians that had no prior experience with TVA. Others have noted similar low complication rates [[3],[4],[5]]. Major complications from TVA in individual mares have been presented in previous reports, including ovarian abscess [1,6], death due to hemorrhage following arterial puncture [7] and laminitis attributed to peritonitis [3].
Because of the increasing use of embryo production via ICSI as a reproductive management tool, TVA is being performed by a growing number of veterinary practices. These practices may not have a mechanism by which to report complications, and practices may prefer not to publish reports of adverse events occurring in their institutions. Two authors of this report (KH and MS) noted that following presentations to groups of practitioners regarding TVA or ICSI, they were often approached by individuals recounting adverse events that occurred during performance of TVA. This led to the question of whether performance of TVA in practice is associated with a greater prevalence of adverse events than is reflected in the published literature. We developed an anonymous survey that was sent to practitioners performing TVA with the goal of assessing their opinions on prevalence of adverse events in practice, and the major types of complications seen. This paper reports the results of that survey, as well as the results of analysis of a large data set (over 14,000 TVAs) from one practice with six operators performing the procedure, to determine the incidence and types of complications seen and the association of complications with operator experience.
2. Materials and methods
2.1. Ethical Approval: The survey and design of Study 1 were submitted to the Institutional Review Board at the University of Pennsylvania, which classified the study as non-human subjects research and thus determined it did not require Institutional Review Board review (notification by email to KH March 8, 2023).
In Study 2, all animal procedures were performed by veterinarians registered with the Brazilian Council of Veterinary Medicine, and the biological material was handled in the ICSI laboratory registered by the Brazilian MAPA (Ministry of Agriculture, Livestock and Supply), following the norms of local legislation. The mares used during the training of operators in Study 2 were animals owned by the company employing the operators; the TVAs were performed to recover oocytes for quality control and research and development purposes. Mares used for the main section of Study 2 were client-owned animals on which TVA was performed for clinical purposes at the request of the owner...
CLICK HERE TO READ THE COMPLETE ARTICLE IN THE ONLINE EDITION OF BREEDING NEWS
