Bhatta Smriti R C, Faraj Radwan
Sheffield Teaching Hospitals NHS Trust, Sheffield S10 2SF, UK.
Case Rep Obstet Gynecol. 2011;2011:189565. doi: 10.1155/2011/189565. Epub 2011 Aug 16.
We present the case of a 27-year-old lady who was seen in the infertility clinic with a history of secondary infertility of a one-year duration. She had a hysteroscopy and Mirena insertion for heavy periods. Coil strings were not found by the GP during first coil check six weeks after insertion. A pelvic ultrasound scan did not show any coil, and it was not investigated further with a possible diagnosis of coil expulsion made. One year following that, she was seen in the infertility clinic. Initial investigations revealed anovulation, and HSG located the coil to be extrauterine. Mirena was removed laparoscopically, and a month following the removal she conceived. She is currently pregnant. This case highlights the effect of extrauterine mirena coils on fertility by possibly causing higher plasma levels of levonorgesterol and resulting suppression of ovulation. Laparoscopic removal of mirena coil can help in restoration of fertility.
我们报告一例27岁女性病例，该患者因继发性不孕一年就诊于不孕不育门诊。她因月经过多接受了宫腔镜检查及曼月乐环置入术。在置入曼月乐环六周后的首次环检查中，全科医生未发现尾丝。盆腔超声扫描未显示任何节育环，考虑可能节育环已排出，未进一步检查。此后一年，她再次就诊于不孕不育门诊。初步检查发现无排卵，子宫输卵管造影显示节育环位于子宫外。通过腹腔镜取出了曼月乐环，取环一个月后她怀孕了。她目前已妊娠。该病例突出了子宫外曼月乐环可能通过导致左炔诺孕酮血浆水平升高并抑制排卵从而对生育能力产生影响。腹腔镜下取出曼月乐环有助于恢复生育能力。
