Pregnancy after mumps: a case report

Abstract

IntroductionOophoritis, a complication of mumps, is said to affect only 5% of all postpubertal women. In this report, we present a case of a 31-year-old Iranian woman with amenorrhea and infertility due to an infantile uterus and atrophic ovaries associated with contracting mumps at a young age. She later successfully carried a healthy baby to term.Case presentationThe patient was diagnosed with oophoritis when she was 8 years of age. She had no menses before treatment. The patient underwent a low-dose contraceptive treatment from age 19 until she was 31 years of age. During this period, the size of her uterus was constantly monitored, which revealed constant yet slow uterine growth. At age 31, Drospil (containing 3 mg of drospirenone and 0.03 mg ethinyl estradiol) treatment was initiated and administered for 3 months, which led to substantial uterine growth and menses. After her uterus had reached a mature size, the patient was referred to an assisted reproductive technology clinic. There she received a donor oocyte that was fertilized with the sperm of her husband. She had a successful low-risk pregnancy after the second embryo transfer.ConclusionLow-dose contraceptive treatment containing progesterone, followed by Drospil, which includes both estradiol and progesterone, had a synergistic effect that led to the growth of the patient’s uterus.

Histologic features, pathogenesis, and long-term effects of viral oophoritis

“…Zika and mumps increased the rate of follicular cell apoptosis (4, 50), although this was not seen with HCV (53). Necrosis and hemorrhage were the major features of CMV oophoritis (11,(13)(14)(15)(16), while atrophic changes were the predominant feature of mumps (1,21).…”

“…A review of the literature revealed fewer histopathological descriptions of mumps oophoritis than CMV oophoritis, although ovarian atrophy and sclerosis seem to be major features of this condition (Table 2) (1,21). In a woman with suspected in utero exposure to mumps, laparoscopy revealed an atrophic endometrium and sclerotic, atrophic ovaries that were approximately one-fourth the size of normal ovaries (1).…”

“…Similarly, this woman's mother, who contracted mumps while in her third trimester of pregnancy, was found to have an atrophic endometrium and atrophic ovaries with functional ovarian tissue replaced by fibrous stroma (1). Shahabi et al (21) describe a woman with a history of prepubertal mumps oophoritis who was found to have atrophic ovaries and an infantile uterus on ultrasound, although no histologic specimens were obtained. In addition to these physical and histologic changes to the ovaries, most of these cases were associated with inappropriately elevated luteinizing hormone and follicle-stimulating hormone (FSH) levels in the postmenopausal range (1,21).…”

“…Shahabi et al (21) describe a woman with a history of prepubertal mumps oophoritis who was found to have atrophic ovaries and an infantile uterus on ultrasound, although no histologic specimens were obtained. In addition to these physical and histologic changes to the ovaries, most of these cases were associated with inappropriately elevated luteinizing hormone and follicle-stimulating hormone (FSH) levels in the postmenopausal range (1,21). Furthermore, these women all showed signs of premature menopause including oligomenorrhea or amenorrhea, infertility, decreased libido, and vasomotor symptoms (1,21).…”

“…In addition to these physical and histologic changes to the ovaries, most of these cases were associated with inappropriately elevated luteinizing hormone and follicle-stimulating hormone (FSH) levels in the postmenopausal range (1,21). Furthermore, these women all showed signs of premature menopause including oligomenorrhea or amenorrhea, infertility, decreased libido, and vasomotor symptoms (1,21). In addition, two patients reported frequent episodes of vaginitis and vaginal discharge (1).…”