Jugular vein thrombosis, subclavian vein thrombosis and right brachiocephalic vein thrombosis after in vitro fertilization and embryo transfer: a case report / 中南大学学报(医学版)

ABSTRACT

To discuss the diagnosis and treatment of jugular vein thrombosis, subclavian vein thrombosis and the right brachiocephalic vein thrombosis after in vitro fertilization and embryo transfer (IVF-ET)cycles in clinical practice. The clinical data regarding a case of jugular vein thrombosis, subclavian vein and the right brachiocephalic vein thrombosis in IVF-ET were reviewed. Clinical characteristics, prevention and treatment of jugular vein thrombosis, subclavian vein and the right brachiocephalic vein thrombosis in IVF-ET were discussed. A woman with secondary infertility underwent an IVF cycle with prolonged protocol controlled ovarian hyperstimulation. The oestradial concentration was 2 495 pg/mL on the day of human chorionic goeadotrophin (hCG). Fifteen occytes were retrieved and 2 embryos were transferred. Nine days after the embryos were transferred, the patient had ascites,hydrothorax and fluid of pelvic cavity accumulating, and was hospitalized. The patient underwent volume expansion and paracentesis, and left the hospital 30 days after the embryo transfer. Her right neck had pain 43 days after the embryo transfer. B ultrasound showed jugular vein thrombosis, subclavian vein and the right brachiocephalic vein thrombosis. The patient underwent low molecular weight heparin anticoagulation and low molecular weight dextran expansion, and left hospital with symptoms improved. She had Caesarean section and had a healthy baby girl. The thrombosis in the IVF-ET was a rare and serious complication. Prevention of ovarian hyperstimulation syndrome (OHSS) may reduce the incidence. The patients had local pain, swelling, skin temperature increased, headache, neck pain, and had to be checked to determine whether there were blood clots. The main treatment was low molecular weight heparin anticoagulation and low molecular weight dextran expansion. Timely Cesarean section is recommended to ensure the safety of perinatal mother and child.