Beth W Rackow1, Pasquale Patrizio. 1. Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut 06520-8063, USA. beth.rackow@yale.edu
Abstract
OBJECTIVE: To report a case of unilateral adnexal torsion and subsequent contralateral adnexal torsion after in vitro fertilization. DESIGN: Case report and literature review. SETTING: Academic fertility center; university hospital. PATIENT(S): A 28-year-old woman with tubal factor infertility conceived with IVF and experienced mild-to-moderate ovarian hyperstimulation syndrome. Right adnexal torsion occurred at 7 weeks of gestation, and laparoscopic detorsion was performed. Subsequent contralateral adnexal torsion occurred at 19 weeks and was managed with laparotomy and salpingo-oophorectomy. INTERVENTION(S): Laparoscopic right adnexal detorsion and laparotomy with salpingo-oophorectomy for left adnexal torsion. MAIN OUTCOME MEASURE(S): Preservation of torsed adnexa and successful pregnancy. RESULT(S): Successful pregnancy and birth complicated by two episodes of adnexal torsion after IVF, and viable right adnexa after laparoscopic detorsion. CONCLUSION(S): Subsequent contralateral adnexal torsion is a rare complication of IVF and can occur in the second trimester. Data support preservation of the torsed adnexa despite the ovary's appearance.
OBJECTIVE: To report a case of unilateral adnexal torsion and subsequent contralateral adnexal torsion after in vitro fertilization. DESIGN: Case report and literature review. SETTING: Academic fertility center; university hospital. PATIENT(S): A 28-year-old woman with tubal factor infertility conceived with IVF and experienced mild-to-moderate ovarian hyperstimulation syndrome. Right adnexal torsion occurred at 7 weeks of gestation, and laparoscopic detorsion was performed. Subsequent contralateral adnexal torsion occurred at 19 weeks and was managed with laparotomy and salpingo-oophorectomy. INTERVENTION(S): Laparoscopic right adnexal detorsion and laparotomy with salpingo-oophorectomy for left adnexal torsion. MAIN OUTCOME MEASURE(S): Preservation of torsed adnexa and successful pregnancy. RESULT(S): Successful pregnancy and birth complicated by two episodes of adnexal torsion after IVF, and viable right adnexa after laparoscopic detorsion. CONCLUSION(S): Subsequent contralateral adnexal torsion is a rare complication of IVF and can occur in the second trimester. Data support preservation of the torsed adnexa despite the ovary's appearance.