Laparoscopic treatment of spontaneous ovarian torsion in a twin pregnancy at 16 weeks after in vitro fertilization: a case report and literature review

Background: Spontaneous ovarian torsion is a rare complication that occurs in fewer than 1 of 5,000 pregnancies but requires emergency treatment. Few reports have described cases of ovarian torsion in multiple pregnancies. According to our literature review, this is the first case report of a successfully laparoscopic management in a twin pregnancy in the second trimester after in vitro fertilization (IVF) in China. More importantly, both the mother and the babies were with a fairly good outcome after surgery. Case Description: We presented a case of spontaneous ovarian torsion in a 33-year-old Chinese woman at 16 weeks in a twin pregnancy after IVF. The patient was treated through emergency laparoscopic procedure. During the procedure, an enlarged ovary with twisted pedicle was identified, and the ovary had turned purple. After the cyst fluid was punctured and vacuumed, the ovary returned to normal size; while the twist was reversed, the ovary regained its pink color. After surgery, the patient recovered well and no signs of ovary dysfunction or abortion were observed. Conclusions: We performed a successfully laparoscopic treatment for ovarian torsion in twin pregnancy after IVF. Our experience may help gynecological clinicians better select appropriate therapeutic management in cases similar to ours.