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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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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     
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:
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.

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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.

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