Life-threatening intraabdominal bleeding after oocyte retrieval successfully managed with angiographic embolization

Objective: To report the first case of massive intraabdominal hemorrhage after transvaginal ultrasonographically guided oocyte retrieval that was successfully managed with angiographic uterine artery embolization. Design: Case report. Setting: Assisted reproduction unit of a tertiary university hospital. Patient(s): A 40-year-old woman with a history of primary infertility presented 10 days after oocyte retrieval because of severe abdominal pain, vomiting, and vaginal bleeding for 3 days. She had a history of mild factor VIII deficiency for 3 years. Intervention(s): Evaluation of the intraabdominal hemorrhage with ultrasonography and angiography. Management of oocyte pickup complicated with intraabdominal hemorrhage. Main Outcome Measure(s): Treatment of massive life-threatening intraabdominal hemorrhage with bilateral uterine artery embolization. Result(s): After transfusion with 2 units of fresh-frozen plasma and packed red blood cell, an interventional radiologist performed percutaneous transcatheter pelvic angiography to detect abnormal vascularization and vascular blush consistent with hemorrhage and then immediate bilateral uterine artery embolization was done. The patient was discharged from the hospital 5 days later without any remarkable complications. Conclusion(s): Angiographic uterine artery embolization under fluoroscopic guidance is a successful nonsurgical approach for the treatment of oocyte pickup-induced life-threatening hemorrhage. (Fertil Steril (R) 2011; 96: e99-102. (C) 2011 by American Society for Reproductive Medicine.)