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Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (3): 415-418    DOI: 10.31083/j.ceog.2020.03.5264
Case Report Previous articles | Next articles
Vibration-related ovarian torsion in a patient undergoing in vitro fertilization: A case report
T.N. Yu1, 2, †, Y.L. Liu3, †, Y.X. Lee1, C.R. Tzeng4, C.H. Chen2, 4, *()
1Graduate Institute of Clinical Medicine, Taipei Medical University, Taipei, Taiwan
2Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Taipei, Taiwan
3Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
4Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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Abstract  

Objective: Ovarian torsion, an uncommon cause of acute abdomen, represents a gynecologic surgical emergency. The incidence of ovarian torsion is high in patients receiving ovarian hyperstimulation due to enlarged ovaries, and ovarian hyperstimulation syndrome (OHSS) also facilitates the occurrence of ovarian torsion. Furthermore, intense exercise and body movement may increase the risk of ovarian torsion. Case Report: Herein, the case of a patient with ovarian torsion after ovarian hyperstimulation is reported here. This ovarian torsion may have been related to the vibration caused when she rode a motorcycle for an entire day on her holiday, 3 days after transvaginal oocyte retrieval. Conclusion: Ovarian torsion is a rare but severe complication in patients receiving assisted reproductive technology (ART), and emergent surgery with conservative treatment is recommended for final diagnosis and management. Exercise and vibration, which may increase the risk of torsion, should be considered as a risk factor for ovarian torsion, particularly in patients receiving ovarian hyperstimulation.

Key words:  Artificial reproductive technology      Ovarian hyperstimulation syndrome      Ovarian torsion      Vibration     
Submitted:  15 May 2019      Accepted:  15 July 2019      Published:  15 June 2020     
Fund: 
ROC, MOST 106-2314-B-016-004/Ministry of Science and Technology, Taiwan
ROC, MOST 107-2314-B-016-065-MY2/Ministry of Science and Technology, Taiwan
TSGH-C106-081/Tri-Service General Hospital
TSGH-C107-082/Tri-Service General Hospital
TSGH-C108-116/Tri-Service General Hospital
TSGH-PH-105-4/Tri-Service General Hospital, Penghu Branch
*Corresponding Author(s):  CHIHUANG CHEN     E-mail:  d102095012@gmail.com
About author:  Contributed equally.

Cite this article: 

T.N. Yu, Y.L. Liu, Y.X. Lee, C.R. Tzeng, C.H. Chen. Vibration-related ovarian torsion in a patient undergoing in vitro fertilization: A case report. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(3): 415-418.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2020.03.5264     OR     https://ceog.imrpress.com/EN/Y2020/V47/I3/415

Figure 1.  — Trans-abdominal ultrasound. (a) Enlarged right ovary (9.8 × 5.1 cm). (b) Enlarged left ovary (9.0 × 4.9 cm) with ascites.

Figure 2.  — Emergent laparoscopy. (a) Partial gangrenous change of the right ovary. (b) Torsion for two rounds along with the ovarian ligament and fallopian tube. (c) Approximately 100 mL of internal bleeding was noted. (d) After detorsion, the ovary regained blood perfusion.

Figure 3.  — (a, b) The left ovary was enlarged without torsion. (c, d) After the procedure, the bilateral ovaries revealed normal perfusion with similar size.

[1] Asfour V., Varma R., Menon P.: "Clinical risk factors for ovarian torsion". J Obstet Gynaecol., 2015, 35, 721.
doi: 10.3109/01443615.2015.1004524 pmid: 26212687
[2] Sasaki K.J., Miller C.E.: "Adnexal torsion: review of the literature". J Minim Invasive Gynecol., 2014, 21, 196.
doi: 10.1016/j.jmig.2013.09.010 pmid: 24126258
[3] Huchon C., Fauconnier A.: "Adnexal torsion: a literature review". Eur J Obstet Gynecol Reprod Biol., 2010, 150, 8.
doi: 10.1016/j.ejogrb.2010.02.006
[4] Pena J.E., Ufberg D., Cooney N., Denis A.L.: "Usefulness of Doppler sonography in the diagnosis of ovarian torsion". Fertil Steril., 2000, 73, 1047.
doi: 10.1016/s0015-0282(00)00487-8 pmid: 10785237
[5] Littman E.D, Rydfors J, Milki A.A.: "Exercise-induced ovarian torsion in the cycle following gonadotrophin therapy: case report". Hum Reprod., 2003, 18, 1641.
doi: 10.1093/humrep/deg338 pmid: 12871875
[6] Gorkemli H., Camus M., Clasen K.: "Adnexal torsion after gonadotrophin ovulation induction for IVF or ICSI and its conservative treatment". Arch Gynecol Obstet., 2002, 267, 4.
doi: 10.1007/s00404-001-0251-x
[7] Tsai H.C., Kuo T.N., Chung M.T., Lin M.Y., Kang C.Y., Tsai Y.C.: "Acute abdomen in early pregnancy due to ovarian torsion following successful in vitro fertilization treatment". Taiwan J Obstet Gynecol., 2015, 54, 438.
doi: 10.1016/j.tjog.2013.08.013 pmid: 26384066
[8] Smith L.P., Oskowitz S.P., Barrett B., Bayer S.R.: "IVF and embryo development subsequent to ovarian torsion occurring during the resumption of meiosis". Reprod Biomed Online., 2010, 21, 418.
doi: 10.1016/j.rbmo.2010.03.030
[9] Nastri C.O., Teixeira D.M., Moroni R.M., Leitao V.M., Martins W.P.: "Ovarian hyperstimulation syndrome: pathophysiology, staging, prediction and prevention". Ultrasound Obstet Gynecol., 2015, 45, 377.
doi: 10.1002/uog.14684 pmid: 25302750
[10] Mattioli S., Graziosi F., Bonfiglioli R., Barbieri G., Bernardelli S., Acquafresca L., et al.: "A case report of vibration-induced hand comorbidities in a postwoman". BMC Musculoskelet Disord., 2011, 12, 47.
doi: 10.1186/1471-2474-12-47 pmid: 21320318
[11] Hudson N., Culley L., Blyth E., Norton W., Pacey A., Rapport F.: "Cross-border-assisted reproduction: a qualitative account of UK travellers' experiences". Hum Fertil (Camb)., 2016, 19, 102.
[12] Hughes E.G., Sawyer A., DeJean D., Adamson G.D.: "Cross-border reproductive care in North America: a pilot study testing a prospective data collection program for in vitro fertilization clinics in Canada and the United States". Fertil Steril., 2016, 105, 786.
doi: 10.1016/j.fertnstert.2015.11.048 pmid: 26690009
[13] Taskin O., Birincioglu M., Aydin A., Buhur A., Burak F., Yilmaz I., et al.: "The effects of twisted ischaemic adnexa managed by detorsion on ovarian viability and histology: an ischaemia-reperfusion rodent model". Hum Reprod., 1998, 13, 2823.
doi: 10.1093/humrep/13.10.2823 pmid: 9804239
[1] N. Smorgick, O. Nir, M. Pekar-Zlotin, S. Maymon, Y. Melcer, R. Maymon. Adnexal torsion: is there a familial tendency?[J]. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(1): 62-64.
[2] I. Korkontzelos, A. Vlachioti, P. Mavridou, A. Rapi, G. Tsanadis, T. Stefos. Heterotopic triplet pregnancy after in vitro fertilization and intracytoplasmatic sperm injection complicated with ovarian hyperstimulation syndrome single twin fetal demise and cervical incompetence: a successful obstetrical outcome[J]. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(6): 1007-1010.
[3] S.B. Cohen, R. Schonmann, J. Boaziz, D. S. Seidman, R. Orvieto, R. Mashiach. Inhibin B level changes during the follicular phase in rats with unilateral ovarian torsion[J]. Clinical and Experimental Obstetrics & Gynecology, 2019, 46(5): 797-799.
[4] F. Yang, H. Hu, P.Z. He, M. Zhang, Y. Qian, Y. Li. Severe ovarian hyperstimulation syndrome in a naturally conceived singleton pregnancy after ovulation induction: a case report[J]. Clinical and Experimental Obstetrics & Gynecology, 2017, 44(2): 292-295.
[5] Y.S. Kim, H.S. Han, J.H. Sang. Adnexal torsion in early pregnancy after assisted reproduction: can the adnexa be saved?[J]. Clinical and Experimental Obstetrics & Gynecology, 2017, 44(1): 135-137.
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