superior vena cava thrombosis in a triplet pregnancy

Objective: Thromboembolism associated with assisted reproductive techniques (ART) is extremely rare. We report a case of thrombosis of the entire superior vena cava associated with severe ovarian hyperstimulation syndrome (OHSS) after ovulation induction with gonadotropins in a triplet pregnancy. Case Report: A 30-year-old woman became pregnant with triplets following human menopausal gonadotropin-induced ovarian stimulation and subsequent artificial insemination with husband's sperm (AIH). She developed an extensive thrombosis of the entire superior vena cava as a late complication of severe OHSS 10 weeks after AIH and was successfully treated with heparin. Two male infants weighing 760 g and 810 g, both with Apgar scores of 3 and 5 at 1 and 5 minutes, respectively, were delivered by cesarean section. Postoperative convalescence was uneventful and both infants were doing well at 6 years of age. Conclusion: The present case report highlights the importance of preventing this potentially dreadful yet completely iatrogenic thromboembolic complication with appropriate heparin therapy throughout pregnancy, particularly in patients with mixed risk factors associated with ART and OHSS.