Fertility and sterility · 2000
Subclavian deep vein thrombosis associated with the use of recombinant follicle-stimulating hormone (Gonal-F) complicating mild ovarian hyperstimulation syndrome.
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Loret de Mola J R, Kiwi R, Austin C, Goldfarb J M
Аннотация
OBJECTIVE: To describe two cases of subclavian deep vein thrombosis (DVT) associated with the use of recombinant gonadotropins and mild ovarian hyperstimulation syndrome (OHSS) and review the literature associated with this condition.
DESIGN: Retrospective study (case report).
SETTING: Tertiary academic IVF program.
PATIENT(S): Two women undergoing IVF with intracytoplasmic sperm injection due to male factor infertility.
INTERVENTION(S): Ovaluation induction with recombinant FSH, IVF, and therapeutic heparinization.
MAIN OUTCOME MEASURE(S): Coagulation studies, resolution of DVT, delivery at term.
RESULT(S): Mild OHSS with left subclavian thrombosis occurred in two patients. Laboratory evaluation revealed normal protein C, protein S, antinuclear antibodies (ANA), and absence of antiphospholipid (APA) and anticardiolipin antibodies (ACA). Antithrombin III levels and coagulation studies were also within normal limits. Both patients tested negative for a factor V Leiden mutation and delivered healthy infants at term.
CONCLUSION(S): Arm swelling associated with the use of gonadotropins during controlled ovarian hyperstimulation should be promptly evaluated and treated. Subclavian vein thrombosis is a rare complication of ovulation induction, and the possibility that recombinant gonadotropins increase the risk for this complication should be further studied.
DESIGN: Retrospective study (case report).
SETTING: Tertiary academic IVF program.
PATIENT(S): Two women undergoing IVF with intracytoplasmic sperm injection due to male factor infertility.
INTERVENTION(S): Ovaluation induction with recombinant FSH, IVF, and therapeutic heparinization.
MAIN OUTCOME MEASURE(S): Coagulation studies, resolution of DVT, delivery at term.
RESULT(S): Mild OHSS with left subclavian thrombosis occurred in two patients. Laboratory evaluation revealed normal protein C, protein S, antinuclear antibodies (ANA), and absence of antiphospholipid (APA) and anticardiolipin antibodies (ACA). Antithrombin III levels and coagulation studies were also within normal limits. Both patients tested negative for a factor V Leiden mutation and delivered healthy infants at term.
CONCLUSION(S): Arm swelling associated with the use of gonadotropins during controlled ovarian hyperstimulation should be promptly evaluated and treated. Subclavian vein thrombosis is a rare complication of ovulation induction, and the possibility that recombinant gonadotropins increase the risk for this complication should be further studied.