title: Subclavian vein thrombosis following IVF and ovarian hyperstimulation: a case report.
abstract: Thromboembolic phenomena are a serious consequence of assisted reproductive technology. We present a case of upper extremity deep vein thrombosis (DVT) at 7 weeks gestation following ovarian hyperstimulation syndrome (OHSS) and IVF. Three weeks after recovering from OHSS, the patient presented with left neck pain and swelling. Ultrasound revealed a thrombus in the left jugular vein and left subclavian vein. Low molecular weight heparin (LMWH) was initiated with symptom resolution within 1 week. The patient remained on LWMH throughout her pregnancy and delivered at term. A literature review showed 97 published cases of thromboembolism following ovulation induction. A majority of these cases was associated with OHSS and pregnancy and the site of involvement was predominantly in the upper extremity and neck. Infertility physicians and obstetricians should be aware of this complication and keep in mind that it may occur weeks after resolution of OHSS symptoms.
authors.affiliation: Department of Obstetrics and Gynecology, Divisions of Reproductive Endocrinology/Infertility and Maternal Fetal Medicine, Stanford University Medical Center, Stanford, CA 94305, USA.
authors.forename: Anjali K
authors.initials: AK
authors.lastname: Rao
authors.forename: Usha
authors.initials: U
authors.lastname: Chitkara
authors.forename: Amin A
authors.initials: AA
authors.lastname: Milki
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000494:pharmacology; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects / Q000379:methods*; D006495:Heparin, Low-Molecular-Weight / Q000378:metabolism; D006801:Humans; D007246:Infertility / Q000628:therapy; D007601:Jugular Veins / Q000473:pathology; D016471:Ovarian Hyperstimulation Syndrome / Q000209:etiology*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000628:therapy*; D013350:Subclavian Vein / Q000473:pathology*; D013923:Thromboembolism; D013997:Time Factors; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000209:etiology*
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight