Renal artery dissection during an in vitro fertilization/intracytoplasmic sperm injection cycle.
OBJECTIVE
To describe a rare case of a renal artery dissection presenting as new-onset hypertension and severe flank pain during an IVF/intracytoplasmic sperm injection (ICSI) cycle.


METHODS
Case report.


METHODS
Private, university-affiliated infertility clinic.


METHODS
A previously healthy 39-year-old woman with secondary infertility undergoing her second IVF/ICSI cycle.


METHODS
Renal artery angioplasty and medical management with multiple antihypertensive agents. Institutional review board approval was not applicable and therefore not obtained.


METHODS
Control of hypertension.


RESULTS
The patient presented with severe flank pain and new-onset severe hypertension on day 5 of ovarian stimulation for IVF/ICSI. At that time her estrogen level was 685 pmol/L. An ultrasound examination showed evidence for infarction of the upper pole of the right kidney, and an angiogram revealed a right renal artery dissection. Blood pressure was eventually controlled after renal artery angioplasty and initiation of multiple antihypertensive agents.


CONCLUSIONS
This is the first report of a renal artery dissection presenting during ovarian stimulation for IVF/ICSI. There were no hemodynamic or serum estrogen changes that could explain a link between the IVF process and the renal artery dissection.
Shmorgun
Doron
D
Ottawa Fertility Centre, University of Ottawa, Ottawa, Ontario, Canada. Electronic address: dshmorgun@conceive.ca.
Claman
Paul
P
Ottawa Fertility Centre, University of Ottawa, Ottawa, Ontario, Canada.
McGregor
Penelope
P
Departments of Family Medicine and Obstetrics, Perth and Smiths Falls District Hospital, Smiths Falls, Ontario, Canada.
McCormick
Brendan
B
Division of Nephrology, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.
D000328:Adult; D017130:Angioplasty; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects*; D006801:Humans; D006978:Hypertension, Renovascular / Q000150:complications / Q000209:etiology / Q000601:surgery; D008297:Male; D010062:Ovulation Induction / Q000009:adverse effects; D016491:Peripheral Vascular Diseases / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D011247:Pregnancy; D012077:Renal Artery / Q000473:pathology* / Q000601:surgery; D020554:Sperm Injections, Intracytoplasmic / Q000009:adverse effects