EC Gynaecology

Aromatase inhibitors are commonly used in sub-fertility management as ovulation induction agents with better efficacy and safety profile. However, unstructured induction without proper monitoring may end up in loss of fertility due to complications such as ovarian torsion. This is a case report of 28 years old female who underwent emergency laparotomy and ovarian detorsion following an immediate timely diagnosis of ovarian hyper-stimulation and ovarian torsion as a consequence of prolonged unsupervised ovulation induction with letrozole. Ovulation induction leads to increased ovarian size and mobility which increases the risk of ovarian torsion. This case highlights the significance of proper patient selection, ensuring individualized treatment protocol and appropriate monitoring during the induction process. At the same time, physician should keep high index of suspicion of ovarian torsion if a female undergoing ovulation induction presented with acute lower abdominal pain. This allows timely diagnosis to preserve the fertility and avoid severe complications.

Keywords: Ovarian Torsion; Aromatase Inhibitors; Ovulation Induction; Fertility

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