RE-15 : Uterine infarction after IVF-ET in a patient with uterine adenomyosis; A case report

Introduction: Uterine adenomyosis is a common benign gynecologic disorder that is characterized by the presence and growth of heterotopic endometrial or endometrium-like structures in the myometrium, with adjacent myometrial hyperplasia. Uterine infarction after IVF-RT in a patient with adenomyosis is rare, although it occurs of complication of uterine artery embolization for fibroids treatment or adenomyosis. CASE PRESENTATION: A 32-year-old nulligravida woman with uterine adenomyosis presented with fever, pelvic pain and chemical abortion after IVF-ET and slightly elevated hCG. Focal uterine infarction was suspected after pelvis MRI demonstrated preserved myometrium between the endometrial cavity and inner margin of the nectrotic myometrium. She underwent treatment for pelvic inflammatory disease with antibiotics and anemia with transfusion. After 2 months later, although follow-up MRI presented interval regress of previously noted possible focal uterine infarct with uterine adenomyosis, symptom has been continued. CONCLUSION: Surgical management of uterine infarction may be considered in the management of uterine infaction after IVF-ET with uterine adenomyosis if future fertility is not desired.