Thrombotic stroke in association with ovarian hyperstimulation and early pregnancy rescued by thrombectomy

Abstract

Severe ovarian hyperstimulation syndrome (OHSS) affects 2–4% of in vitro fertilization (IVF) patients, which may rarely result in an ischemic stroke secondary to a hypercoagulable state. We describe a case of a 38-year-old IVF patient who developed early-onset OHSS with a viable pregnancy who presented at 18 days post embryo transfer with an ischemic stroke resulting from a thrombus in the right middle cerebral artery. As the use of recombinant tissue plasminogen activator was relatively contraindicated owing to a recent intra-abdominal drain placement, a radiologically guided thrombectomy was performed. This resulted in neurological improvement in the mother and the birth of a normal term infant, without significant ionizing effects to the developing embryo.