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Early pregnancy is elusive and robust
E AL-Mizyen1, C G Barnick, J G Grudzinskas
1Specialist IVF Registrar, St Bartholomews and The Royal London School of Medicine and Dentistry, Royal London Hospital, London, E1 1BB.
Early Pregnancy
|December 26, 2001
Summary
A live birth resulted from ovarian diathermy and hysteroscopy performed inadvertently during early pregnancy in a woman with clomiphene citrate-resistant polycystic ovarian syndrome. This case highlights the importance of pregnancy testing before pelvic procedures.
Area of Science:
- Reproductive Endocrinology
- Gynecologic Surgery
Background:
- Polycystic ovarian syndrome (PCOS) often presents with clomiphene citrate resistance.
- Laparoscopic ovarian diathermy and hysteroscopy are established treatments for PCOS-related infertility.
- Inadvertent early pregnancy can occur in women undergoing fertility treatments.
Observation:
- A woman with clomiphene citrate-resistant PCOS underwent bilateral laparoscopic ovarian diathermy, hysteroscopy, and dye test during early, unrecognized pregnancy.
- Pre-operative assessments included pelvic ultrasound and various hormone level tests (hCG, LH, FSH, Prolactin, T, SHBG, DHAS, E2).
Findings:
- The patient had a successful live birth following the inadvertently performed procedures.
- The pregnancy proceeded without apparent complications related to the surgical interventions.
Implications:
- Women of reproductive age scheduled for elective pelvic surgery should undergo pregnancy testing prior to procedures.
- Effective contraception or abstinence is crucial for women undergoing fertility treatments or with irregular cycles.
- This case underscores the need for vigilance regarding potential pregnancy in women with PCOS undergoing gynecologic procedures.