乳癌治療前における卵子凍結保存目的の採卵後、卵巣出血にて緊急手術を要した症例

抄録

Objective: We report a case of ovarian hemorrhage that occurred in a woman who underwent laparoscopic surgery for oocyte aspiration for mature oocyte cryopreservation. Additionally, we have presented a literature review.

Design: Case report and literature review.

Patient(s): A 36-year-old woman.

Intervention(s): Ultrasonography, computed tomography, and laparoscopic surgery.

Main outcome, Measure(s): Availability of laparoscopic surgery to treat ovarian hemorrhage after oocyte aspiration.

Result: A 36-year-old woman underwent surgery for breast cancer followed by hormone and radiation therapy. She desired to undergo oocyte preservation for fertility preservation. She received ovulation-inducing hormone therapy and underwent transvaginal aspiration after which she developed ovarian hemorrhage necessitating emergency laparoscopic surgery. Intraoperatively, the left ovary was edematous, and bleeding from a large fissure of the ovary was detected. Bipolar coagulation could not control the bleeding, and we sutured the fissure of the ovary for satisfactory hemostasis. Following uneventful postoperative recovery, radiation therapy was initiated on postoperative day 28.

Conclusion: We report a case of ovarian hemorrhage after oocyte aspiration for mature oocyte cryopreservation. Currently, social oocyte cryopreservation is gaining widespread acceptance. Therefore, oocyte preservation is possible in women with cancer, as well as in women desirous of future pregnancy. Given this scenario, such complications are expected to increase. Laparoscopic surgery is a less invasive option to avoid such complications and facilitates prompt institution of treatment in women with cancer. The ovaries are highly fragile after stimulation, and bipolar coagulation alone cannot control bleeding. Thus, laparoscopically placed sutures are usually required in such cases.