Clin Exp Reprod Med.  2014 Dec;41(4):174-177. 10.5653/cerm.2014.41.4.174.

Uterine infarction in a patient with uterine adenomyosis following biochemical pregnancy

• Lee JY
• Hwang KR
• Won KH
• Lee DY
• Jeon HW
• Moon MH

• KMID: 2049077
• DOI: http://doi.org/10.5653/cerm.2014.41.4.174

Abstract

Adenomyosis is a common gynecological disorder characterized by the presence of endometrial glands and stroma deep within the myometrium associated with myometrial hypertrophy and hyperplasia. Focal uterine infarction after IVF-ET in a patient with adenomyosis following biochemical pregnancy has not been previously reported, although it occurs after uterine artery embolization in order to control symptoms caused by fibroids or adenomyosis. We report a case of a nulliparous woman who had uterine adenomyosis presenting with fever, pelvic pain and biochemical abortion after undergoing an IVF-ET procedure and the detection of a slightly elevated serum hCG. Focal uterine infarction was suspected after a pelvic magnetic resonance imaging demonstrated preserved myometrium between the endometrial cavity and inner margin of the necrotic myometrium. This case demonstrates that focal uterine infarction should be considered in the differential diagnosis of acute abdominal pain, vaginal bleeding and infectious signs in women experiencing biochemical abortion after an IVF-ET procedure.

Keyword

Adenomyosis; Infarction; In vitro fertilization

MeSH Terms

Abdominal Pain
Adenomyosis*
Animals
Diagnosis, Differential
Female
Fertilization in Vitro
Fever
Humans
Hyperplasia
Hypertrophy
Infarction*
Leiomyoma
Magnetic Resonance Imaging
Mice
Myometrium
Pelvic Pain
Pregnancy*
Uterine Artery Embolization
Uterine Hemorrhage