An acute psychiatric episode following transvaginal oocyte retrieval.
Psychological disorders of infertile patients are traditionally thought to be chronic, to advance gradually, and to be long-term problems. We describe a patient in whom an acute psychiatric episode developed immediately after transvaginal ultrasound-guided oocyte retrieval. A 34 year old women without history of psychiatric disturbance or adverse reaction to drugs suffered an acute psychiatric episode immediately after oocyte retrieval. She exhibited tachycardia, tachypnoea, transient hypertension and limb rigidity, as well as alterations to stupor and posture. Her vital signs stabilized and she opened her eyes 6 h later, but she persistently raised her head to the left and stared blankly without response to external stimuli. Nine hours later, she was able to look around but remained unresponsive to stimuli. Aphasia was noted in the next morning and a wishful thinking of having delivered a baby was noted in the afternoon. Memory loss was noted on the third day. The patient was diagnosed as having dissociative amnesia and was discharged after three courses of supportive psychotherapy. Assisted reproductive technology-related acute psychiatric episodes, which may initially mimic brainstem stroke, are rare; however, attention should be paid to high-risk patients, and they should be offered elective psychological counselling.
Hwang
Jiann-Loung
JL
Department of Obstetrics and Gynaecology, Shin Kong Wu Ho-Su Memorial Hospital, Shan-Chung City, Taiwan.
Kuo
Min-Che
MC
Hsieh
Bih-Chwen
BC
Chang
Chien-Hui
CH
Jou
Lih-Chih
LC
Chen
Wei-Hung
WH
Wu
Gong-Jhe
GJ
D000208:Acute Disease; D000328:Adult; D000647:Amnesia / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000628:therapy; D001523:Mental Disorders / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D009865:Oocytes; D011613:Psychotherapy; D020858:Tissue and Organ Harvesting / Q000009:adverse effects* / Q000379:methods; D014463:Ultrasonography; D014621:Vagina