menotropins and Thrombosis

Recent methods for induction of ovulation in the woman are described. The only indication for use of these medications is induction of ovulation and pregnancy. In properly selected patients, the success rate is quite high, but treatment has undesirable side effects which occasionally may be severe.

Topics: Affective Symptoms; Animals; Anovulation; Blood Coagulation Disorders; Body Temperature; Castration; Chorionic Gonadotropin; Clomiphene; Depression, Chemical; Female; Gonadotropins; Gonadotropins, Pituitary; Humans; Infertility, Female; Menotropins; Ovarian Diseases; Ovulation; Pregnancy; Pregnancy, Multiple; Thrombosis

Topics: Amenorrhea; Ascites; Chorionic Gonadotropin; Female; Gonadotropins; Gonadotropins, Equine; Gonadotropins, Pituitary; Humans; Hydrothorax; Menotropins; Ovarian Cysts; Ovarian Diseases; Ovulation; Pregnancy; Pregnancy, Multiple; Thrombosis

The case reported consists of thrombosis of the left internal jugular vein occurring on the 22nd week of amenorrhea of a pregnancy achieved by IVF. No etiological factor other than biochemical ovarian hyperstimulation was found. Maternal outcome was positive but intrauterine fetal death occurred 7 weeks later at 29 weeks of amenorrhea. The late occurrence of this thrombosis after ovarian hyperstimulation need to be stressed.

Topics: Adult; Female; Fertilization in Vitro; Fetal Death; Humans; Jugular Veins; Menotropins; Ovulation Induction; Pregnancy; Pregnancy Complications, Cardiovascular; Pregnancy Trimester, Second; Pregnancy Trimester, Third; Thrombosis

Coagulation and fibrinolytic profiles have been studied in two groups of sterility patients receiving low dosage regimens of human gonadotropins for ovarian stimulation. This investigation was prompted by a report of two patients with severe episodes of intravascular coagulation associated with periods of "hyperstimulation" from these drugs. No statistically significant changes were found as a result of administration of one ampoule of human menopausal (HMG) or pituitary gonadotropins (HPG) for 8 days followed by 9000 units of human chorionic gonadotrophin (HCG). A course of 2-3 ampoules HMG on alternate days for longer periods of time prior to administration of HCG also failed to produce significant alterations of the coagulation or fibrinolytic mechanisms. In two patients with severe hyperstimulation there were elevated levels of factor V, platelets, fibrinogen, profibrinolysin, and fibrinolytic inhibitors. Generation of thromboplastin was also increased when plasma was diluted one to fifty in the thromboplastin generation test. These results suggest a possibly increased coagulation potential in patients with "hyperstimulation syndrome" but not in those receiving the low dosage regimens of human gonadotropins more commonly used for ovarian stimulation at the present time.

Topics: Blood Coagulation; Blood Coagulation Factors; Blood Coagulation Tests; Chorionic Gonadotropin; Estrogens; Factor V; Female; Fibrinogen; Fibrinolysis; Gonadotropins; Gonadotropins, Pituitary; Humans; Infertility, Female; Meigs Syndrome; Menotropins; Progestins; Thromboplastin; Thrombosis; Time Factors