Case report
Aphasia: an early uncommon complication of ovarian stimulation without ovarian hyperstimulation syndrome

https://doi.org/10.1016/S1472-6483(10)60760-2Get rights and content

Abstract

Thromboembolic disease associated with assisted reproductive techniques is extremely rare. A 21-year-old woman with primary infertility underwent an ovulation induction cycle with luteal long protocol. Twenty-four hours following oocyte retrieval, the patient complained of difficulty in speaking. On neurological examination, mild disorientation, motor aphasia, and right-sided hypoesthesia were noted. Brain computed tomography scanning without contrast revealed left parietal lob infarct. Brain magnetic resonance imaging (MRI), MRI angiography (MRA) and perfusion MRI demonstrated an occlusion of the posterior division of the left middle cerebral artery (MCA). Physical, ultrasound examinations and laboratory test evaluation failed to reveal ovarian hyperstimulation syndrome. Except for ovarian stimulation, no additional risk factors for stroke were shown. Following anticoagulation and speech therapy, the patient recovered completely within eight months. One year after the left MCA thrombosis, she conceived spontaneously and had an uncomplicated vaginal delivery of a live male infant weighing 2900 g at 38 weeks gestation. This case supports that ovulation induction and assisted reproductive techniques may be a newly recognized cause of cerebral infarction in otherwise healthy women.

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Dr Aygul Demirol obtained her medical degree and further degree in the specialization of Obstetrics and Gynecology at Hacettepe University, School of Medicine, Ankara, Turkey. She is Clinical Director of the CLINIC Women Health, Infertility and IVF Center and she is currently working in the clinical and laboratory site of the IVF Unit. She is participating in research projects related to infertility and IVF.

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Dr Aygul Demirol obtained her medical degree and further degree in the specialization of Obstetrics and Gynecology at Hacettepe University, School of Medicine, Ankara, Turkey. She is Clinical Director of the CLINIC Women Health, Infertility and IVF Center and she is currently working in the clinical and laboratory site of the IVF Unit. She is participating in research projects related to infertility and IVF.

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