Adnexal Torsion During Controlled Ovarian Stimulation: A Case Report

Ekasak Thiangphak, Phawat Matemanosak, Suwadee Wirotkarun

Abstract

A 34-year-old nulliparous woman with polycystic ovarian syndrome presented with mild discomfort in her right abdomen three hours before her scheduled retrieval. She underwent a transvaginal oocyte retrieval. Oocytes were obtained from the ovary; however, the right ovary was inaccessible as it was located above the uterine fundus. Consequently, the decision was made to abandon retrieval from the right ovary. After the procedure, the pain continued, and a physical examination indicated signs of peritonitis. Right ovarian torsion was suspected, leading to laparoscopic detorsion with transabdominal oocyte retrieval from the untwisted ovary. One mature oocyte was retrieved from the torsion-affected ovary, resulting in an embryonic arrest at the morula stage. Additionally, we reviewed the literature on the outcomes of in vitro fertilization cycles in women with ovarian torsion before oocyte retrieval.

 Keywords

in vitro fertilization; ovarian stimulation; ovarian torsion

 Full Text:

PDF

References

Bodri D, Guillén JJ, Polo A, Trullenque M, Esteve C, Coll O. Complications related to ovarian stimulation and oocyte retrieval in 4052 oocyte donor cycles. Reprod Biomed Online 2008;17:237-43.

Spitzer D, Wirleitner B, Steiner H, Zech NH. Adnexal torsion in pregnancy after assisted reproduction – case study and review of the literature. Geburtsh Frauenh 2012;72:716-20.

Krishnan S, Kaur H, Bali J, Rao K. Ovarian torsion in infertility management - Missing the diagnosis means losing the ovary: A high price to pay. J Hum Reprod Sci 2011;4:39-42.

Smith LP, Oskowitz SP, Barrett B, Bayer SR. IVF and embryo development subsequent to ovarian torsion occurring during the resumption of meiosis. Reprod Biomed Online 2010;21:418-21.

Robson S, Kerin JF. Acute adnexal torsion before oocyte retrieval in an in vitro fertilization cycle. Fertil Steril 2000;73:650-1.

Stefanidis K, Grammatis M, Pappas K, Haidopoulos D, Chronopoulos K, Pantos K, et al. Empty follicle syndrome associated with ovarian torsion in an in vitro fertilization program. JSLS 2002;6:215-6.

Inoue D, Asada Y. Successful oocyte retrieval after follicular fluid aspiration in suspicious of ovarian torsion. Cureus 2020;12:e12192.

Naert MN, Baker S, Attaman J, Morris ME, Souter I, Fitz VW. Ovarian torsion during ovarian stimulation prior to trigger followed by successful oocyte retrieval: a case report. Case Rep Womens Health 2023;10:e00495.

Mortimer RM, Gordon C, Srouji S. In vitro fertilization cycle outcomes for a patient undergoing oocyte retrieval following ovarian torsion. CRSLS 2023;10:e2022.00092.

Chang-Patel EJ, Palacios-Helgeson LK, Gould CH. Adnexal torsion: a review of diagnosis and management strategies. Curr Opin Obstet Gynecol 2022;34:196-203.

Nizar K, Deutsch M, Filmer S, Weizman B, Beloosesky R, Weiner Z. Doppler studies of the ovarian venous blood flow in the diagnosis of adnexal torsion. J Clin Ultrasound 2009;37:436-9.

Mashiach R, Melamed N, Gilad N, Ben-Shitrit G, Meizner I. Sonographic diagnosis of ovarian torsion: accuracy and predictive factors. J Ultrasound Med 2011;30:1205-10.

Govaerts I, Devreker F, Delbaere A, Revelard P, Englert Y. Short-term medical complications of 1500 oocyte retrievals for in vitro fertilization and embryo transfer. Eur J Obstet Gynecol Reprod Biol 1998;77:239-43.

Gorkemli H, Camus M, Clasen K. Adnexal torsion after gonadotrophin ovulation induction for IVF or ICSI and its conservative treatment. Arch Gynecol Obstet 2002;267:4-6.

Zhu W, Li X, Chen X, Fu Z. Conservative management of adnexal torsion via transvaginal ultrasound guided ovarian cyst aspiration in patients with ovarian hyperstimulation. Fertil Steril 2008;89:229.e1-3.

DOI: http://dx.doi.org/10.31584/jhsmr.20251155

Refbacks

  • There are currently no refbacks.
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.