Thromboembolism and in vitro fertilization - a systematic review

Sennström, Maria; Rova, Karin; Hellgren, Margareta; Hjertberg, Ragnhild; Nord, Eva; Thurn, Lars; Lindqvist, Pelle G.

doi:10.1111/aogs.13147

Cited by 64 publications

(69 citation statements)

References 44 publications

(111 reference statements)

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“…Little data is available regarding risk of thromboembolism during oocyte or embryo cryopreservation alone (i.e. without fresh embryo transfer), but concern for this complication is supported by the observation that risk of venous thromboembolism is significantly higher in the first trimester of pregnancy following in vitro fertilization and fresh embryo transfer (and 100-fold when treatment was complicated by OHSS), as compared to spontaneous pregnancies [ 22 ]. Aspirin was also considered for this patient, which may reduce the risk of OHSS as well as thromboembolism [ 9 ], but the decision was made to proceed without aspirin due to concern for hemostasis during oocyte retrieval.…”

Section: Discussionmentioning

confidence: 99%

Oocyte cryopreservation in the setting of a vascular endothelial growth factor (VEGF)-producing paraneoplastic syndrome: a case report and review of literature

Spurlin

Brady

2020

Fertil Res and Pract

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Background Many reproductive aged women with new oncologic diagnoses choose to undergo emergency oocyte or embryo cryopreservation prior to initiating potentially gonadal toxic oncologic therapies. Ovarian hyperstimulation syndrome (OHSS) is a potential complication of these treatments and can be particularly dangerous in these patients due to their underlying medical illness and by delaying lifesaving oncology treatment. This case report details a multipronged approach to OHSS prevention in a patient with a paraneoplastic syndrome defined by overproduction of vascular endothelial growth factor (VEGF), which is also primarily responsible for OHSS. Case presentation A 29 year old nulligravid woman was diagnosed with a rare multisystem paraneoplastic syndrome (Polyradiculoneuropathy, organomegaly, endocrinopathy, monoclonal plasma cell disorder and skin changes, known as POEMS) and presented for fertility preservation consultation prior to autologous stem cell transplant. She successfully underwent oocyte cryopreservation without complications due to aggressive OHSS prophylaxis with both a dopamine agonist and aromatase inhibitor during and after stimulation and a gonadotropin releasing hormone agonist (GnRH-A) for final oocyte maturation, without delay in her subsequent oncology treatment. Conclusions This is the first report of a patient with POEMS undergoing controlled ovarian hyperstimulation (COH). Oocyte cryopreservation was successful and without complications due to a combination of prophylactic measures against OHSS (cabergoline, letrozole and GnRH-A trigger) and close collaboration between reproductive endocrinology and oncology. This case demonstrates the use of combined measures in targeting VEGF overproduction and OHSS risk during COH.

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Section: Discussionmentioning

confidence: 99%

Oocyte cryopreservation in the setting of a vascular endothelial growth factor (VEGF)-producing paraneoplastic syndrome: a case report and review of literature

Spurlin

Brady

2020

Fertil Res and Pract

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“…[ 15 16 17 ] A recent systematic review has confirmed that the antepartum risk of VTE after IVF is doubled (odds ratio, 2.18; 95% confidence interval, 1.63–2.92) in comparison with the background normal pregnant population. [ 18 ] The incidence of VTE has been reported as 0.1%–0.5% of all IVF cycles started and the risk of arterial thrombosis is much lower. Nearly 70% of reported cases are venous thrombosis and 30% are arterial.…”

Section: Discussionmentioning

confidence: 99%

Assisted reproductive techniques in a patient with history of venous thromboembolism: A case report and review of literature

2018

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We report a patient with a history of venous thrombosis following oral contraceptive pills who was planned for in vitro fertilization (IVF)-intracytoplasmic sperm injection for male factor infertility. This article discusses the mechanisms for predisposition to thrombosis during assisted reproduction in patients at high risk. Assessment of risk before commencement of treatment, use of mild stimulation, antagonist protocol, avoiding ovarian hyperstimulation, use of gonadotropin-releasing hormone agonist trigger and avoiding exposure to human chorionic gonadotropin, frozen embryo transfer in a natural cycle, single embryo transfer, avoiding multiple pregnancy, and use of prophylactic or therapeutic anticoagulation are the various risk-reduction strategies that must be adopted during IVF treatment to reduce the risk of thrombosis to that of natural conception.

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“…However, a very recent analysis by Sennström et al . [ 11 ] reported that IVF results in twofold increase in the risk of thromboembolic events when compared to non-IVF pregnancies. Moreover, hospitalized IVF patients due to ovarian hyperstimulation syndrome had 100-fold increased risk of thromboembolic events when compared to non-IVF pregnant population.…”

Section: Discussionmentioning

confidence: 99%

Human menopausal gonadotropin-induced bioprosthetic valve thrombosis

et al. 2018

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Bioprosthetic valve thrombosis (BPVT) is a rare but potentially life-threatening complication. Human menopausal gonadotropin (hMG) is commonly used for ovulation induction and has been associated with arterial and venous thrombosis. We reported a case of BPVT related to in vitro fertilization in a 39-year-old female, who underwent redo mitral valve replacement. To the best of our knowledge, this is the first case of hMG-induced BPVT in a young female patient.

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Thromboembolism and in vitro fertilization - a systematic review

Cited by 64 publications

References 44 publications

Oocyte cryopreservation in the setting of a vascular endothelial growth factor (VEGF)-producing paraneoplastic syndrome: a case report and review of literature

Oocyte cryopreservation in the setting of a vascular endothelial growth factor (VEGF)-producing paraneoplastic syndrome: a case report and review of literature

Assisted reproductive techniques in a patient with history of venous thromboembolism: A case report and review of literature

Human menopausal gonadotropin-induced bioprosthetic valve thrombosis

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