Thromboembolism after ovarian stimulation: successful management of a woman with superior sagittal sinus thrombosis after IVF and embryo transfer: Case report

Author： Ou Yu‐Che

Publisher： Oxford University Press

ISSN： 1460-2350

Source： Human Reproduction, Vol.18, Iss.11, 2003-11, pp. : 2375-2381

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Abstract

The current literature was reviewed in order to analyse the clinical manifestations, progression and management, and pregnancy outcome of thromboembolism in infertile patients undergoing ovarian stimulation. The first case of superior sagittal sinus thrombosis following IVF that was successfully managed with intracranial thrombectomy is also reported. This retrospective cohort study comprised 65 women who experienced thromboembolism after ovarian stimulation (64 from other published studies and the present case report). Thrombosis attack occurred at a mean (±SD) of 25.5 ± 20.1 days after oocyte retrieval. The onset timing in the intracranial thrombosis group (10.2 ± 4.6 days) was less (P < 0.05)="" than="" in="" those="" experiencing="" thromboembolism="" at="" other="" sites.="" ovarian="" hyperstimulation="" syndrome="" (ohss),="" haemoconcentration="" and="" high="" serum="" estradiol="" level="" were="" noted="" in="" 79,="" 62="" and="" 54%="" of="" women="" respectively.="" forty‐eight="" of="" 55="" patients="" (87%)="" who="" received="" anticoagulation="" recovered="" without="" sequelae.="" among="" patients="" willing="" to="" continue="" pregnancy,="" 32%="" succeeded="" in="" term="" delivery="" with="" all="" healthy="" babies,="" and="" 23%="" were="" ongoing="" pregnancies.="" in="" conclusion,="" ovarian="" stimulation="" cycles="" accompanying="" high="" serum="" estradiol="" levels,="" haemoconcentration="" or="" ohss="" are="" at="" potential="" risk="" of="" thromboembolism.="" dose‐adjusted="" heparinization="" is="" recommended="" as="" the="" first‐line="" treatment="" of="" choice,="" while="" intravascular="" thrombolysis="" or="" operative="" thrombectomy="" is="" an="" aggressive="" but="" effective="" treatment.="" continuation="" of="" pregnancy="" is="" considered="" safe,="" without="" any="" increased="" risk="" of="" fetal="" congenital="" anomalies.="">