Delayed Intra-Abdominal Bleeding Following Trans-Vaginal Ultrasonography Guided Oocyte Retrieval for in Vitro Fertilization in Patients at Risk for Thrombo-Embolic Events under Anticoagulant Therapy.

We report herein, two cases of massive delayed (2 and 4 days) intra abdominal hemorrhage following ovum pick-up (OPU), in patients at risk for thrombo-embolic events, who concomitantly used therapeutic doses of low molecular weight heparin (LMWH). We discuss the possible mechanisms involved in causing the aforementioned delayed bleeding, and call for re-evaluation of the presently accepted anticoagulant co-treatment regimen. These case reports should direct physicians' attention and keep them alert, while conducting IVF treatment to this subgroup of high risk patients.