Thromboembolism after ovarian stimulation: successful management of a woman with superior sagittal sinus thrombosis after IVF and embryo transfer: Case report
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 man...
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| Veröffentlicht in: | Human reproduction (Oxford) 2003-11, Vol.18 (11), p.2375-2381 |
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| creator | Ou, Yu‐Che Kao, Yeh‐Lin Lai, Shung‐Lon Kung, Fu‐Tsai Huang, Fu‐Jen Chang, Shiuh‐Young ChangChien, Chan‐Chao |
| description | 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. |
| doi_str_mv | 10.1093/humrep/deg470 |
| format | Article |
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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.</description><identifier>ISSN: 0268-1161</identifier><identifier>ISSN: 1460-2350</identifier><identifier>EISSN: 1460-2350</identifier><identifier>DOI: 10.1093/humrep/deg470</identifier><identifier>PMID: 14585890</identifier><identifier>CODEN: HUREEE</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Adult ; Anticoagulants - therapeutic use ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiology. Vascular system ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Embryo Transfer ; Estradiol - blood ; Female ; Fertilization in Vitro ; Heparin - therapeutic use ; Humans ; Key words: intracranial thrombectomy/IVF/ovarian hyperstimulation syndrome/thromboembolism ; Medical sciences ; Oocytes ; Ovarian Hyperstimulation Syndrome - complications ; Ovulation Induction - adverse effects ; Pregnancy ; Pregnancy Complications, Cardiovascular - blood ; Pregnancy Complications, Cardiovascular - drug therapy ; Pregnancy Complications, Cardiovascular - etiology ; Sagittal Sinus Thrombosis - blood ; Sagittal Sinus Thrombosis - complications ; Sagittal Sinus Thrombosis - drug therapy ; Sagittal Sinus Thrombosis - etiology ; Thromboembolism - blood ; Thromboembolism - complications ; Thromboembolism - drug therapy ; Thromboembolism - etiology ; Tissue and Organ Harvesting</subject><ispartof>Human reproduction (Oxford), 2003-11, Vol.18 (11), p.2375-2381</ispartof><rights>European Society of Human Reproduction and Embryology 2003</rights><rights>2004 INIST-CNRS</rights><rights>Copyright Oxford University Press(England) Nov 2003</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c456t-fd983515233c913c35d5a284ac99aba552eaf73fb4fc69e34ac3901c797c94813</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,778,782,1581,27907,27908</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15252447$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14585890$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ou, Yu‐Che</creatorcontrib><creatorcontrib>Kao, Yeh‐Lin</creatorcontrib><creatorcontrib>Lai, Shung‐Lon</creatorcontrib><creatorcontrib>Kung, Fu‐Tsai</creatorcontrib><creatorcontrib>Huang, Fu‐Jen</creatorcontrib><creatorcontrib>Chang, Shiuh‐Young</creatorcontrib><creatorcontrib>ChangChien, Chan‐Chao</creatorcontrib><title>Thromboembolism after ovarian stimulation: successful management of a woman with superior sagittal sinus thrombosis after IVF and embryo transfer: Case report</title><title>Human reproduction (Oxford)</title><addtitle>Hum. Reprod</addtitle><addtitle>Hum. Reprod</addtitle><description>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.</description><subject>Adult</subject><subject>Anticoagulants - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiology. Vascular system</subject><subject>Diseases of the peripheral vessels. Diseases of the vena cava. 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Vascular system</topic><topic>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</topic><topic>Embryo Transfer</topic><topic>Estradiol - blood</topic><topic>Female</topic><topic>Fertilization in Vitro</topic><topic>Heparin - therapeutic use</topic><topic>Humans</topic><topic>Key words: intracranial thrombectomy/IVF/ovarian hyperstimulation syndrome/thromboembolism</topic><topic>Medical sciences</topic><topic>Oocytes</topic><topic>Ovarian Hyperstimulation Syndrome - complications</topic><topic>Ovulation Induction - adverse effects</topic><topic>Pregnancy</topic><topic>Pregnancy Complications, Cardiovascular - blood</topic><topic>Pregnancy Complications, Cardiovascular - drug therapy</topic><topic>Pregnancy Complications, Cardiovascular - etiology</topic><topic>Sagittal Sinus Thrombosis - blood</topic><topic>Sagittal Sinus Thrombosis - complications</topic><topic>Sagittal Sinus Thrombosis - drug therapy</topic><topic>Sagittal Sinus Thrombosis - etiology</topic><topic>Thromboembolism - blood</topic><topic>Thromboembolism - complications</topic><topic>Thromboembolism - drug therapy</topic><topic>Thromboembolism - etiology</topic><topic>Tissue and Organ Harvesting</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ou, Yu‐Che</creatorcontrib><creatorcontrib>Kao, Yeh‐Lin</creatorcontrib><creatorcontrib>Lai, Shung‐Lon</creatorcontrib><creatorcontrib>Kung, Fu‐Tsai</creatorcontrib><creatorcontrib>Huang, Fu‐Jen</creatorcontrib><creatorcontrib>Chang, Shiuh‐Young</creatorcontrib><creatorcontrib>ChangChien, Chan‐Chao</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Nucleic Acids Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Human reproduction (Oxford)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ou, Yu‐Che</au><au>Kao, Yeh‐Lin</au><au>Lai, Shung‐Lon</au><au>Kung, Fu‐Tsai</au><au>Huang, Fu‐Jen</au><au>Chang, Shiuh‐Young</au><au>ChangChien, Chan‐Chao</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Thromboembolism after ovarian stimulation: successful management of a woman with superior sagittal sinus thrombosis after IVF and embryo transfer: Case report</atitle><jtitle>Human reproduction (Oxford)</jtitle><stitle>Hum. Reprod</stitle><addtitle>Hum. Reprod</addtitle><date>2003-11-01</date><risdate>2003</risdate><volume>18</volume><issue>11</issue><spage>2375</spage><epage>2381</epage><pages>2375-2381</pages><issn>0268-1161</issn><issn>1460-2350</issn><eissn>1460-2350</eissn><coden>HUREEE</coden><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.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>14585890</pmid><doi>10.1093/humrep/deg470</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Oxford University Press Journals All Titles (1996-Current) |
| subjects | Adult Anticoagulants - therapeutic use Biological and medical sciences Blood and lymphatic vessels Cardiology. Vascular system Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous Embryo Transfer Estradiol - blood Female Fertilization in Vitro Heparin - therapeutic use Humans Key words: intracranial thrombectomy/IVF/ovarian hyperstimulation syndrome/thromboembolism Medical sciences Oocytes Ovarian Hyperstimulation Syndrome - complications Ovulation Induction - adverse effects Pregnancy Pregnancy Complications, Cardiovascular - blood Pregnancy Complications, Cardiovascular - drug therapy Pregnancy Complications, Cardiovascular - etiology Sagittal Sinus Thrombosis - blood Sagittal Sinus Thrombosis - complications Sagittal Sinus Thrombosis - drug therapy Sagittal Sinus Thrombosis - etiology Thromboembolism - blood Thromboembolism - complications Thromboembolism - drug therapy Thromboembolism - etiology Tissue and Organ Harvesting |
| title | Thromboembolism after ovarian stimulation: successful management of a woman with superior sagittal sinus thrombosis after IVF and embryo transfer: Case report |
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