Successful Same-Cycle Blastocyst Transfer following Laparoscopic Ovarian Detorsion: A Report of Two Cases and Literature Review.

Mohamad Irani,David B Seifer,Reshef Tal,Richard V Grazi

doi:10.1155/2014/806378

Mohamad Irani, David B Seifer + Show 2 more

Open Access

https://doi.org/10.1155/2014/806378

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Abstract

Ovarian stimulation increases the risk of ovarian torsion. During an in vitro fertilization (IVF) cycle, the effects of ovarian torsion on retrieved oocytes and subsequent pregnancy chances are not clear. Moreover, no cases of ovarian torsion occurring following oocyte retrieval but prior to same-cycle embryo transfer have been reported. Such cases present a clinical dilemma with respect to optimal timing of embryo transfer. We report two cases of a 41-year-old and a 32-year-old infertility patients undergoing IVF who were diagnosed with ovarian torsion within several days following oocyte retrieval. Both patients were treated by early laparoscopic evaluation and detorsion followed by day five embryo transfer, resulting in successful pregnancies. Therefore, after prompt laparoscopic ovarian untwisting of a torsed ovary following egg retrieval, embryo transfer may be performed as originally scheduled during the concurrent cycle leading to favorable pregnancy outcomes.

Highlights

Ovarian torsion occurs when the ovary makes a partial or complete rotation on its ligamentous supports, often resulting in compromise of its blood supply
No cases of ovarian torsion following oocyte retrieval but prior to embryo transfer have been reported, and they present a clinical dilemma with respect to embryo transfer timing
We report two cases of ovarian torsion that occurred one day and three days after egg retrieval and were appropriately diagnosed and treated by laparoscopic detorsion, followed by embryo transfer on day five of the same in vitro fertilization (IVF) cycle

Summary

Introduction

Ovarian torsion occurs when the ovary makes a partial or complete rotation on its ligamentous supports, often resulting in compromise of its blood supply. It accounts for 3% of gynecological emergencies [1]. Successful laparoscopic management of ovarian torsion during an IVF cycle prior to oocyte retrieval has been reported. We report two cases of ovarian torsion that occurred one day and three days after egg retrieval and were appropriately diagnosed and treated by laparoscopic detorsion, followed by embryo transfer on day five of the same IVF cycle. We report the first two cases of ovarian torsion after oocyte retrieval resulting in successful pregnancies following same-cycle day five embryo transfer

Case 1

Case 2

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Discussion