title: Thrombocythemia and hemoperitoneum after transvaginal oocyte retrieval for in vitro fertilization.
abstract: OBJECTIVE
  To present the first report of massive hemoperitoneum in a case of essential thrombocythemia after transvaginal oocyte retrieval for IVF and review the relevant literature related to the management of patients with this condition.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Assisted conception unit of a tertiary care university hospital in the United Kingdom.
  
  
  METHODS
  A 37-year-old woman with essential thrombocythemia who developed massive intra-abdominal bleeding after transvaginal oocyte retrieval for IVF.
  
  
  METHODS
  Emergency laparotomy and right salpingoophorectomy.
  
  
  RESULTS
  Resuscitation of the patient.
  
  
  METHODS
  Overall management of the patient is discussed.
  
  
  CONCLUSIONS
  The management of patients with essential thrombocythemia at the childbearing period poses a difficult problem. Fertility may be reduced, and an adverse outcome of pregnancy due to thrombotic or bleeding complications is a matter of concern. A multidisciplinary approach with close and early cooperation with the hematologists before initiation of IVF therapy for patients with essential thrombocythemia is essential. Efforts should be made to reduce the platelet count and assess the platelet function before embarking on IVF, keeping in mind the double jeopardy from bleeding and thrombosis in these cases.
authors.affiliation: IVF Unit, Department of Reproductive Medicine and Science, Hammersmith Hospital, Imperial College School of Medicine, Du Cane Road, London W12 0HS, United Kingdom. salemshawarby@yahoo.com
authors.forename: Salem A
authors.initials: SA
authors.lastname: El-Shawarby
authors.forename: Raul A
authors.initials: RA
authors.lastname: Margara
authors.forename: Geoffrey H
authors.initials: GH
authors.lastname: Trew
authors.forename: Michael A
authors.initials: MA
authors.lastname: Laffan
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Lavery
mesh_terms: D000328:Adult; D001803:Blood Transfusion; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects*; D006465:Hemoperitoneum / Q000209:etiology* / Q000601:surgery; D006801:Humans; D009865:Oocytes / Q000166:cytology*; D012489:Salpingostomy; D013922:Thrombocytosis / Q000209:etiology* / Q000601:surgery