International Journal of Infertility & Fetal Medicine

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VOLUME 14 , ISSUE 3 ( September-December, 2023 ) > List of Articles

CASE REPORT

Laparoscopic Ovarian Detorsion in Stimulation Cycle of IVF Prior Oocyte Retrieval and a Successful Outcome: A Rare Case Report

Sunil Eshwar, Poornima Kinila, Smrithi D Nayak, Shivani Chandan

Keywords : Case report, Cycle salvage, In vitro fertilization stimulation and oocyte pick up, Laparoscopic ovarian detorsion

Citation Information : Eshwar S, Kinila P, Nayak SD, Chandan S. Laparoscopic Ovarian Detorsion in Stimulation Cycle of IVF Prior Oocyte Retrieval and a Successful Outcome: A Rare Case Report. Int J Infertil Fetal Med 2023; 14 (3):139-142.

DOI: 10.5005/jp-journals-10016-1319

License: CC BY-NC 4.0

Published Online: 28-11-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Aim: This case report shows the rare occurrence of ovarian torsion prior to oocyte pick. Clinical acumen and timely diagnosis could save the ovary for future fertility and health. Background: Ovarian torsion is an acute surgical emergency and is commonly encountered in ovarian cysts larger than 5 cm and in polycystic ovaries and also hyperstimulated ovaries postoocyte pick up and in ovarian hyperstimulation syndrome (OHSS). Case description: A 34 years woman stimulated for in vitro fertilization (IVF) under the standard flexible gonadotropin-releasing hormone (GnRH) antagonist protocol presented on the 8th day of stimulation with slow insidious onset gradually increasing squeezing pain in the right iliac fossa and lumbar area. Clinical examination and investigations by Doppler ultrasound (USG) revealed a diagnosis of right ovarian torsion. She successfully underwent a laparoscopic detorsion and fixation of the ovary following which she underwent a subsequent oocyte retrieval 36 hours after trigger. All oocytes were obtained from the normal left ovary. None of the follicles from the torted right ovary revealed any oocytes. Conclusion: She underwent frozen blastocyst embryo transfer which led to a successful pregnancy. Clinical significance: Ovarian torsion is an acute surgical emergency that if not tackled could be life-threatening. The stimulation cycle could proceed further after detorsion of the ovary and the cycle could be continued with mature good quality oocytes although obtained from the contralateral ovary. The cycle was salvaged which resulted in organ salvage, significant time gain, and prevention of cycle cancellation costs. In an era of minimalistic surgery, laparoscopic de torsion and cycle and organ salvage could be an answer to ovarian torsion cases with preserved blood supply.


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