One thing is true in medicine and that is that you never want to be an interesting patient! Seriously. You should aim to have the condition that your doctor sees all the time and knows exactly what to do. As soon as you start getting a lot of "hmmms" and "wow, that is unusual'" then you may feel free to panic a little bit. Not a lot. Just a little. Because being an interesting patient doesn't preclude a happy outcome! It just means that when you are successful then the medical team feels like they deserve a victory lap. So here is a headline for today's blog about an interesting patient....
NC IVF results in only 2nd pregnancy ever reported in a patient with endometriosis hemorrhagic ascites undergoing IVF!
Ascites is a medical condition in which excess fluid accumulates in the abdomen. Usually we see this in young patients with OHSS. Oncologists see it in patients with cancer. This past year I saw a patient that had recurrent ascites resulting from severe endometriosis. How rare is this condition? Well there have only been 63 reported cases worldwide since 1954 ! That's pretty darn rare.
The patient had first noticed the problem in 2009 and had undergone several procedures to drain the blood fluid that accumulated slowly every day. Lupron dried up the fluid but she came to see me because she wanted to conceive.
We performed a laparoscopy in April 2011 and I was shocked to see how severe the endometriosis was at that time. I thought that it was actually ovarian cancer but the pathology proved it to be endometriosis.
Her options for fertility treatment were limited since we were concerned that the use of fertility drugs could make the whole process a lot worse. Her tubes were very damaged by the endometriosis that was everywhere so she needed IVF…..
Natural Cycle IVF to the rescue! She underwent one cycle of NC IVF. Egg collection was a bit unusual as the ovary was literally floating around in her abdominal fluid but we got a healthy egg, a beautiful embryo and a positive pregnancy test. She is currently almost 12 weeks pregnant and doing great! Another first for NC IVF and Dominion Fertility!