国际生殖健康/计划生育 ›› 2022, Vol. 41 ›› Issue (2): 115-118.doi: 10.12280/gjszjk.20210305

• 病例报告 • 上一篇    下一篇

卵巢子宫内膜异位囊肿患者穿刺取卵和IVF-ET后妊娠合并盆腔脓肿一例并文献复习

李潇萌, 王德婧()   

  1. 563000 遵义医科大学附属医院生殖中心
  • 收稿日期:2021-07-12 出版日期:2022-03-15 发布日期:2022-03-29
  • 通讯作者: 王德婧 E-mail:2430085462@qq.com

Pregnancy Combined with Pelvic Abscess after Oocyte Retrieval and IVF-ET in A Patient with Ovarian Endometriotic Cyst: A Case Report and Literature Review

LI Xiao-meng, WANG De-jing()   

  1. Reproductive Center, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou Province, China
  • Received:2021-07-12 Published:2022-03-15 Online:2022-03-29
  • Contact: WANG De-jing E-mail:2430085462@qq.com

摘要:

报告1例在穿刺取卵和体外受精-胚胎移植(IVF-ET)术后发生盆腔脓肿的卵巢子宫内膜异位囊肿患者。该患者24岁,不孕4年,发现多囊卵巢综合征1年,曾采取阴道卵巢囊肿穿刺术。给予达英-35调经治疗1个周期,完善术前检查后行助孕治疗,穿刺取卵、IVF-ET后10 d,腹痛伴发热,抗炎治疗无效后急诊行腹腔镜探查术,术中诊断盆腔脓肿、急性盆腔炎;二次行盆腔脓肿清除+引流术,术后给予静脉抗炎,获治愈出院。分析该病例资料,并复习国内外报道的行辅助生殖助孕后发生盆腔脓肿的8例病例资料,以期提高对辅助生殖助孕后相关并发症的认识。既往合并子宫内膜异位囊肿的不孕症患者行穿刺取卵术后发生盆腔脓肿的概率较高,此外,慢性盆腔炎、阴道炎、反复多次操作史均为发生盆腔脓肿的高危因素。盆腔脓肿的临床表现以腹痛、发热为主,一经确诊后应积极治疗,若抗生素治疗无效,应及时考虑手术治疗。

关键词: 生殖技术, 辅助, 体外受精, 胚胎移植, 子宫内膜异位症, 盆腔感染, 盆腔脓肿

Abstract:

A case of pregnancy combined with pelvic abscess after oocyte retrieval and IVF-ET in a patient with ovarian endometriotic cyst was reported. This patient aged 24 years, with infertile for 4 years and polycystic ovary syndrome for 1 year, underwent vaginal ovarian cyst puncture. Diane-35 menstruation treatment was given for 1 cycle. After preoperative examination, assisted reproductive treatment was performed. After 10 days of ovulation extraction and IVF-ET, patient suffered from abdominal pain and fever. After anti-inflammatory therapy failed, laparoscopic exploration was performed, pelvic abscess and acute pelvic inflammation were diagnosed. After that, the pelvic abscess removal and drainage were performed again. Intravenous anti-inflammatory was given after the operation. The patient was cured and discharged. The data of this case were analyzed, and 8 cases of pelvic abscess after assisted reproduction were combined and reviewed, in order to improve the understanding of related complications after assisted reproduction. Infertile patients with ovarian endometriotic cyst were more likely to develop pelvic abscess after oocyte retrieval in the past. In addition, chronic pelvic inflammatory disease, vaginitis and the history of repeated operations are of three risk factors of pelvic abscess. The main clinical manifestations of pelvic abscess are abdominal pain and fever. Patients should be treated actively once diagnosed. If antibiotic treatment failed, surgical treatment should be considered in time.

Key words: Reproductive techniques, assisted, Fertilization in vitro, Embryo transfer, Endometriosis, Pelvic infection, Pelvic abscess