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Successful Same-Cycle Blastocyst Transfer following Laparoscopic Ovarian Detorsion: A Report of Two Cases and Literature Review.

Irani M, Tal R, Seifer DB, Grazi RV - Case Rep Obstet Gynecol (2014)

Bottom Line: During an in vitro fertilization (IVF) cycle, the effects of ovarian torsion on retrieved oocytes and subsequent pregnancy chances are not clear.Such cases present a clinical dilemma with respect to optimal timing of embryo transfer.Both patients were treated by early laparoscopic evaluation and detorsion followed by day five embryo transfer, resulting in successful pregnancies.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Maimonides Medical Center, 4802 Tenth Avenue, Brooklyn, NY 11219, USA.

ABSTRACT
Ovarian stimulation increases the risk of ovarian torsion. During an in vitro fertilization (IVF) cycle, the effects of ovarian torsion on retrieved oocytes and subsequent pregnancy chances are not clear. Moreover, no cases of ovarian torsion occurring following oocyte retrieval but prior to same-cycle embryo transfer have been reported. Such cases present a clinical dilemma with respect to optimal timing of embryo transfer. We report two cases of a 41-year-old and a 32-year-old infertility patients undergoing IVF who were diagnosed with ovarian torsion within several days following oocyte retrieval. Both patients were treated by early laparoscopic evaluation and detorsion followed by day five embryo transfer, resulting in successful pregnancies. Therefore, after prompt laparoscopic ovarian untwisting of a torsed ovary following egg retrieval, embryo transfer may be performed as originally scheduled during the concurrent cycle leading to favorable pregnancy outcomes.

No MeSH data available.


Related in: MedlinePlus

Left ovary measuring 75.4 mm × 55.4 mm.
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Related In: Results  -  Collection


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fig1: Left ovary measuring 75.4 mm × 55.4 mm.

Mentions: One day after egg retrieval, the patient presented to our office complaining of severe left lower quadrant pain, associated with nausea and vomiting. Her vital signs were stable and abdominal exam revealed mild left lower quadrant tenderness with no rebound or guarding. Transvaginal sonogram (Figure 1) showed left ovary measuring 75 × 55 mm, right ovary measuring 71 × 43 mm, mild free fluid, and normal Doppler blood flow to both ovaries. Her white blood cell count was 20.4 × 103 cells/μL with 90% neutrophils. Due to high suspicion of left ovarian torsion, the patient was transferred immediately to the hospital for diagnostic laparoscopy. At laparoscopy, left ovarian torsion with multiple small cysts was noted. The left ovary was found to be twisted 180° around the infundibulopelvic ligament and had a viable pinkish color. The left ovary was untwisted successfully and three small cysts were drained. The patient tolerated the procedure well and the postoperative recovery was uneventful.


Successful Same-Cycle Blastocyst Transfer following Laparoscopic Ovarian Detorsion: A Report of Two Cases and Literature Review.

Irani M, Tal R, Seifer DB, Grazi RV - Case Rep Obstet Gynecol (2014)

Left ovary measuring 75.4 mm × 55.4 mm.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4020476&req=5

fig1: Left ovary measuring 75.4 mm × 55.4 mm.
Mentions: One day after egg retrieval, the patient presented to our office complaining of severe left lower quadrant pain, associated with nausea and vomiting. Her vital signs were stable and abdominal exam revealed mild left lower quadrant tenderness with no rebound or guarding. Transvaginal sonogram (Figure 1) showed left ovary measuring 75 × 55 mm, right ovary measuring 71 × 43 mm, mild free fluid, and normal Doppler blood flow to both ovaries. Her white blood cell count was 20.4 × 103 cells/μL with 90% neutrophils. Due to high suspicion of left ovarian torsion, the patient was transferred immediately to the hospital for diagnostic laparoscopy. At laparoscopy, left ovarian torsion with multiple small cysts was noted. The left ovary was found to be twisted 180° around the infundibulopelvic ligament and had a viable pinkish color. The left ovary was untwisted successfully and three small cysts were drained. The patient tolerated the procedure well and the postoperative recovery was uneventful.

Bottom Line: During an in vitro fertilization (IVF) cycle, the effects of ovarian torsion on retrieved oocytes and subsequent pregnancy chances are not clear.Such cases present a clinical dilemma with respect to optimal timing of embryo transfer.Both patients were treated by early laparoscopic evaluation and detorsion followed by day five embryo transfer, resulting in successful pregnancies.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Maimonides Medical Center, 4802 Tenth Avenue, Brooklyn, NY 11219, USA.

ABSTRACT
Ovarian stimulation increases the risk of ovarian torsion. During an in vitro fertilization (IVF) cycle, the effects of ovarian torsion on retrieved oocytes and subsequent pregnancy chances are not clear. Moreover, no cases of ovarian torsion occurring following oocyte retrieval but prior to same-cycle embryo transfer have been reported. Such cases present a clinical dilemma with respect to optimal timing of embryo transfer. We report two cases of a 41-year-old and a 32-year-old infertility patients undergoing IVF who were diagnosed with ovarian torsion within several days following oocyte retrieval. Both patients were treated by early laparoscopic evaluation and detorsion followed by day five embryo transfer, resulting in successful pregnancies. Therefore, after prompt laparoscopic ovarian untwisting of a torsed ovary following egg retrieval, embryo transfer may be performed as originally scheduled during the concurrent cycle leading to favorable pregnancy outcomes.

No MeSH data available.


Related in: MedlinePlus