Hughes Noemi J, Choudhury Saeed M S R, Liyanage Sidath H, Hussain Munawar
Department of Obstetrics and Gynaecology, Southend University Hospital NHS Foundation Trust, Prittlewell Chase, Southend-on-Sea SS0 0RY, UK.
Department of Medicine, Southend University Hospital NHS Foundation Trust, Southend-on-Sea, UK.
Ther Adv Reprod Health. 2021 Jul 31;15:26334941211023542. doi: 10.1177/26334941211023542. eCollection 2021 Jan-Dec.
We report a rare case of fertilisation (IVF) with egg donation complicated by a subarachnoid haemorrhage (SAH). Haemostatic changes related to IVF are known to increase risk of venous thrombosis; however, less is known regarding the risk of arterial events such as cerebrovascular accidents (CVA). Matrix metalloprotease-9 (MMP-9) upregulated in IVF patients may have a role in arterial aneurysm formation, which is the most common cause of SAH. Further research is required to assess the benefit of screening for risk of CVA and the best way to manage this in the IVF population. This may have implications for the ethics of offering certain procedures such as egg donation to women with pre-existing risk factors.
我们报告了一例罕见的体外受精(IVF)卵子捐赠病例,该病例并发蛛网膜下腔出血(SAH)。已知与IVF相关的止血变化会增加静脉血栓形成的风险;然而,关于动脉事件如脑血管意外(CVA)的风险了解较少。IVF患者中上调的基质金属蛋白酶-9(MMP-9)可能在动脉瘤形成中起作用,而动脉瘤是SAH最常见的原因。需要进一步研究以评估在IVF人群中筛查CVA风险的益处以及最佳管理方法。这可能对向有既往风险因素的女性提供卵子捐赠等特定程序的伦理问题产生影响。