title: Renal artery dissection during an in vitro fertilization/intracytoplasmic sperm injection cycle.
abstract: 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.
authors.affiliation: Ottawa Fertility Centre, University of Ottawa, Ottawa, Ontario, Canada. Electronic address: dshmorgun@conceive.ca.
authors.forename: Doron
authors.initials: D
authors.lastname: Shmorgun
authors.affiliation: Ottawa Fertility Centre, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Claman
authors.affiliation: Departments of Family Medicine and Obstetrics, Perth and Smiths Falls District Hospital, Smiths Falls, Ontario, Canada.
authors.forename: Penelope
authors.initials: P
authors.lastname: McGregor
authors.affiliation: Division of Nephrology, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Brendan
authors.initials: B
authors.lastname: McCormick
mesh_terms: 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