Massive deep vein thrombosis in a patient with antithrombin III deficiency undergoing ovarian stimulation for in vitro fertilization.
OBJECTIVE
To present the first report of a thromboembolic complication in early pregnancy after ovarian hyperstimulation for IVF in a patient with AT III deficiency who was treated successfully and subsequently delivered a healthy male infant at 32 weeks of gestation.


METHODS
Case report.


METHODS
Hospital-based clinic for reproductive medicine.


METHODS
A 28-year-old woman who consulted our IVF clinic with a 3.5-year history of primary infertility.


METHODS
Intravenous heparin therapy.


RESULTS
The patient responded adequately to heparin therapy and was discharged home on SC heparin. A primary cesarean section was performed at 32 weeks of gestation because of poor fetal growth and transverse lie.


CONCLUSIONS
We stress the importance of obtaining a thorough personal and family history before initiation of ovarian hyperstimulation. Measuring activity of AT III, protein C, and protein S in patients with a suspicious history of thromboembolic episodes occurring at an early age may lead to the implementation of appropriate prophylactic measures, preventing potentially life-threatening complications.
Department of Obstetrics and Gynecology, Cornell University Medical College, New York, New York.
I
I
Kligman
N
N
Noyes
C A
CA
Benadiva
Z
Z
Rosenwaks
D000328:Adult; D020152:Antithrombin III Deficiency; D005260:Female; D005307:Fertilization in Vitro; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010062:Ovulation Induction; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy*; D011250:Pregnancy Complications, Hematologic / Q000188:drug therapy*; D011256:Pregnancy Outcome; D013923:Thromboembolism / Q000188:drug therapy*; D013924:Thrombophlebitis / Q000188:drug therapy*
D006493:Heparin