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Case Reports
. 2020 Dec;37(12):3017-3023.
doi: 10.1007/s10815-020-01969-2. Epub 2020 Oct 10.

Successful in vitro fertilization in women with Fontan physiology

Yuli Y Kim  1   2   3 , Lisa D Levine  4 , Sara L Partington  5   6   7 , Prakash A Patel  8 , Emily Ruckdeschel  5   6   7 , Suneeta Senapati  9 , Clarisa R Gracia  9
Affiliations
Case Reports

Successful in vitro fertilization in women with Fontan physiology

Yuli Y Kim et al. J Assist Reprod Genet. 2020 Dec.

Abstract

Purpose: Patients with single ventricle anatomy palliated with Fontan operation are at risk for thromboembolism, arrhythmia, and heart failure rendering pregnancy high risk or even contraindicated. Infertility and high rates of first trimester miscarriage are not uncommon. In vitro fertilization (IVF) with or without gestational surrogacy can be an option, but poses risks during ovarian stimulation, oocyte retrieval, and the post-procedural period. We present six cases of women with complex congenital heart disease status post Fontan operation who underwent successful IVF.

Methods: Case series from a single-center tertiary care setting.

Results: Indications for referral were cardiac or fertility concerns for pregnancy of the congenital cardiologist. One woman had mild volume overload after oocyte retrieval requiring furosemide and one experienced post-operative colitis. There were no thrombotic complications.

Conclusions: A multidisciplinary team-based approach can result in successful oocyte retrieval and IVF in women with complex congenital heart disease and Fontan physiology.

Keywords: Case report; Complex congenital heart disease; In vitro fertilization; Multidisciplinary.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Multidisciplinary care pathway for in vitro fertilization for Fontan females. REI, reproductive endocrinology and infertility; MFM, maternal fetal medicine; ACHD, adult congenital heart disease; MAC, monitored anesthesia care; OR, operating room; PACU, post-anesthesia care unit
See this image and copyright information in PMC

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