Thromboembolic Phenomena After Ovarian Stimulation With Human Gonadotrophins

Targeting the vascular endothelial growth factor system to prevent ovarian hyperstimulation syndrome

“…It is especially aggravated during gestation. This process leads, on the one hand, to haemoconcentration and the risk of thromboembolism and impaired general perfusion, and, on the other, to abdominal distension, which may produce abdominal discomfort and breathing difficulties (Mozes et al, 1965).…”

“…Typically, OHSS is a complication of ovarian stimulation with gonadotrophins followed by the administration of hCG to trigger the final steps of oocyte maturation (Mozes et al, 1965). It is more frequently seen when a strong ovarian response occurs, characterized by the development of a large number of follicles, high estradiol (E 2 ) values and enlarged ovaries (Rizk and Smitz, 1992).…”

Gonadotrophins, livedo reticularis, and strokes.

“…Previously reported cases have been linked with the ovarian overstimulation syndrome, which causes a rapid shift in body fluid balance, abdominal pain, ascites, pleural effusions, hemoconcentration, and blood hypercoagulability. 4 - 5 In this case, although clinical features of ovarian overstimulation were absent, it is possible that gonadotrophininduced hyperestrogenism favored thrombosis via a transient increase in clotting factors (VII, IX, XI) or in platelet aggregability. 6 This observation also suggests that women with livedo reticularis could be at risk for stroke when treated with gonadotrophins and should probably have a careful dermatological examination before their prescription.…”

Risk of thrombosis in women with malignancies undergoing ovarian stimulation for fertility preservation

“…A causal relationship between ovarian stimulation and thrombosis was firstly suggested in a case report published in The Lancet in 1965 (Mozes et al, 1965;ESHRE, 2013). Following this first case, a number of papers have reported this complication and .100 cases have been published (Stewart et al, 1997;Rao et al, 2005;Chan and Ginsberg, 2006;Chan and Dixon, 2008;Chan, 2009;Chipwete et al, 2009;Nelson, 2009;Seong et al, 2010;Dorais et al, 2011;Fleming et al, 2012;Mmbaga et al, 2012;Meshksar et al, 2013).…”