Dyspnea After In Vitro Fertilization

Ziad R. Hubayter, MD, MPH

Disclosures

June 10, 2015

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Background

A 33-year-old woman, gravida 0, presents to the emergency department owing to sudden onset of shortness of breath 1 week after in vitro fertilization (IVF). Her shortness of breath began acutely earlier in the day, but she states that for the past few days, she has had generalized abdominal pain associated with distention; nausea; and occasional nonbloody, nonbilious vomiting. Her pain became worse overnight, and she states that it now hurts in her abdomen when she takes a deep breath. She also cannot lie flat because it exacerbates both the pain and the difficulty with breathing.

She has a known history of polycystic ovary syndrome (PCOS) and has failed to conceive for several years. Three weeks before presentation, controlled ovarian stimulation was performed with gonadotropins. A total of 25 oocytes were retrieved. The peak estradiol during ovarian stimulation was 4638 pg/mL. She then underwent transvaginal ultrasonography-guided oocyte retrieval, followed by embryo transfer 1 week before presentation.

The patient's medical history is otherwise unremarkable. Other than the recent hormonal therapy, her only medication has been a daily multivitamin, and she has no known drug allergies. She denies smoking or the use of drugs or alcohol.

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