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Hum. Reprod. Advance Access first published online on August 5, 2005
This version published online on September 27, 2005
Human Reproduction, doi:10.1093/humrep/dei235
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved.
Received March 21, 2005
Revised May 12, 2005
Accepted June 29, 2005

Article

Subclavian vein thrombosis following IVF and ovarian stimulation and IVF: a case report

Anjali K. Rao 1, Usha Chitkara 1, and Amin A. Milki 1*

1 Department of Obstetrics and Gynecology, Divisions of Reproductive Endocrinology/Infertility and Maternal Fetal Medicine, Stanford University Medical Center, Stanford, CA 94305, USA

* To whom correspondence should be addressed.
Amin A. Milki, E-mail: amilki{at}stanford.edu


  Abstract

Thromboembolic phenomena are a serious consequence of assisted reproductive technology. We present a case of upper extremity deep vein thrombosis (DVT) at 7 weeks gestation following ovarian hyperstimulation syndrome (OHSS) and IVF. Three weeks after recovering from OHSS, the patient presented with left neck pain and swelling. Ultrasound revealed a thrombus in the left jugular vein and left subclavian vein. Low molecular weight heparin (LMWH) was initiated with symptom resolution within 1 week. The patient remained on LWMH throughout her pregnancy and delivered at term. A literature review showed 97 published cases of thromboembolism following ovulation induction. A majority of these cases was associated with OHSS and pregnancy and the site of involvement was predominantly in the upper extremity and neck. Infertility physicians and obstetricians should be aware of this complication and keep in mind that it may occur weeks after resolution of OHSS symptoms.

Keywords: IVF/ovarian hyperstimulation/subclavian vein thrombosis.
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