title: Delayed intra-abdominal bleeding following trans-vaginal ultrasonography guided oocyte retrieval for in vitro fertilization in patients at risk for thrombo-embolic events under anticoagulant therapy.
abstract: We report herein, two cases of massive delayed (2 and 4 days) intra abdominal hemorrhage following ovum pick-up (OPU), in patients at risk for thrombo-embolic events, who concomitantly used therapeutic doses of low molecular weight heparin (LMWH). We discuss the possible mechanisms involved in causing the aforementioned delayed bleeding, and call for re-evaluation of the presently accepted anticoagulant co-treatment regimen. These case reports should direct physicians' attention and keep them alert, while conducting IVF treatment to this subgroup of high risk patients.
authors.affiliation: Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Ramat Gan, Israel ; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Roy
authors.initials: R
authors.lastname: Mashiach
authors.affiliation: Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Ramat Gan, Israel ; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Stockheim
authors.affiliation: Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Ramat Gan, Israel ; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Mati
authors.initials: M
authors.lastname: Zolti
authors.affiliation: Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Ramat Gan, Israel ; Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.
authors.forename: Raoul
authors.initials: R
authors.lastname: Orvieto