Highlights a rare case of multiple spontaneous arterial dissections and serious complications potentially associated with long-term infertility treatment involving gonadotropins and estrogen.
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Raises caution for vascular events during prolonged infertility regimens; hypothesis-generating association requiring prospective confirmation.
A 36-year-old woman developed multiple spontaneous arterial dissections in both renal arteries, the carotid artery, superior mesenteric artery, and vertebral artery, but not the aorta, and she suffered a renal infarction and subarachnoid hemorrhage within a short period of time. She had been undergoing frequent injections of human chorionic gonadotropin and human menopausal gonadotropin, together with oral estrogen therapy, during a 5-year infertility treatment regimen. As she had no other history of any disorder affecting the arterial walls, this therapy is suspected to have caused the multiple arterial deformities. Although cases of isolated arterial dissection are occasionally reported, it is rare for multiple dissections and serious symptoms to occur simultaneously.
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Wakino et al. (2005) studied this question.
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