Horstkamp B, Lübke M, Kentenich H, Riess H, Büscher U, Lichtenegger W
Department of Gynecology and Obstetrics, Virchow University Hospital, Humboldt University Berlin, Germany.
Hum Reprod. 1996 Feb;11(2):280-2. doi: 10.1093/humrep/11.2.280.
We present a case of a 24 year old woman who became pregnant (twins) after human menopausal gonadotrophin (HMG)-induced ovarian stimulation, in-vitro fertilization (IVF) and subsequent embryo transfer. She developed a right internal jugular vein thrombosis as a complication of severe ovarian hyperstimulation syndrome (OHSS) 28 days after embryo transfer. The thrombosis developed in spite of anticoagulation with low-dose heparin. Later a resistance to activated protein C (APC) or Dahlbäck disease was diagnosed. Due to a new test procedure (accelerin inactivation test), the diagnosis was possible even under anticoagulation treatment. The coincidence of hyperstimulation and internal jugular vein thrombosis with the concurrent diagnosis of resistance to APC has not been published previously. The benefit of general screening for resistance to APC before admission to the IVF programme should be weighed. Targeted selection of a group of high-risk women would therefore be made possible.
我们报告一例24岁女性病例，该女性在接受人绝经期促性腺激素（HMG）诱导的卵巢刺激、体外受精（IVF）及随后的胚胎移植后怀孕（双胞胎）。胚胎移植28天后，她出现了右颈内静脉血栓形成，这是严重卵巢过度刺激综合征（OHSS）的一种并发症。尽管使用了低剂量肝素进行抗凝，血栓仍形成。后来诊断出对活化蛋白C（APC）抵抗或达勒贝克病。由于一种新的检测方法（加速素灭活试验），即使在抗凝治疗下也能做出诊断。此前尚未有关于过度刺激与颈内静脉血栓形成同时并发APC抵抗诊断的报道。应权衡在进入IVF程序前对APC抵抗进行常规筛查的益处。因此，有针对性地选择一组高危女性将成为可能。
