Subarachnoid haemorrhage in pregnancy after in vitro fertilisation with egg donation: a case report and review of the literature

Noemi J Hughes; Saeed M S R Choudhury; Sidath H Liyanage; Munawar Hussain

doi:10.1177/26334941211023542

Subarachnoid haemorrhage in pregnancy after in vitro fertilisation with egg donation: a case report and review of the literature

Ther Adv Reprod Health. 2021 Jul 31:15:26334941211023542. doi: 10.1177/26334941211023542. eCollection 2021 Jan-Dec.

Authors

Noemi J Hughes¹, Saeed M S R Choudhury², Sidath H Liyanage³, Munawar Hussain⁴

Affiliations

¹ Department of Obstetrics and Gynaecology, Southend University Hospital NHS Foundation Trust, Prittlewell Chase, Southend-on-Sea SS0 0RY, UK.
² Department of Medicine, Southend University Hospital NHS Foundation Trust, Southend-on-Sea, UK.
³ Department of Radiology, Southend University Hospital NHS Foundation Trust, Southend-on-Sea, UK.
⁴ Department of Obstetrics and Gynaecology, Southend University Hospital NHS Foundation Trust, Southend-on-Sea, UK.

Abstract

We report a rare case of in vitro fertilisation (IVF) with egg donation complicated by a subarachnoid haemorrhage (SAH). Haemostatic changes related to IVF are known to increase risk of venous thrombosis; however, less is known regarding the risk of arterial events such as cerebrovascular accidents (CVA). Matrix metalloprotease-9 (MMP-9) upregulated in IVF patients may have a role in arterial aneurysm formation, which is the most common cause of SAH. Further research is required to assess the benefit of screening for risk of CVA and the best way to manage this in the IVF population. This may have implications for the ethics of offering certain procedures such as egg donation to women with pre-existing risk factors.

Keywords: CVA; IVF; SAH; aneurysm; fertility; pregnancy; thrombosis.

Publication types

Case Reports