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Published on: February 4, 2015
Renal artery dissection during an in vitro fertilization/intracytoplasmic sperm injection cycle
Doron Shmorgun1, Paul Claman1, Penelope McGregor2
1Ottawa Fertility Centre, University of Ottawa, Ottawa, Ontario, Canada.
Objective:
To describe a rare case of a renal artery dissection presenting as new-onset hypertension and severe flank pain during an IVF/intracytoplasmic sperm injection (ICSI) cycle.
Design:
Case report.
Setting:
Private, university-affiliated infertility clinic.
Patient(S):
A previously healthy 39-year-old woman with secondary infertility undergoing her second IVF/ICSI cycle.
Intervention(S):
Renal artery angioplasty and medical management with multiple antihypertensive agents. Institutional review board approval was not applicable and therefore not obtained.
Main Outcome Measure(S):
Control of hypertension.
Result(S):
The patient presented with severe flank pain and new-onset severe hypertension on day 5 of ovarian stimulation for IVF/ICSI. At that time her estrogen level was 685 pmol/L. An ultrasound examination showed evidence for infarction of the upper pole of the right kidney, and an angiogram revealed a right renal artery dissection. Blood pressure was eventually controlled after renal artery angioplasty and initiation of multiple antihypertensive agents.
Conclusion(S):
This is the first report of a renal artery dissection presenting during ovarian stimulation for IVF/ICSI. There were no hemodynamic or serum estrogen changes that could explain a link between the IVF process and the renal artery dissection.
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