Case Reports

Post-IVF hormone stimulation cataract: a case report

Case Report Details

First Author: K.Zimmer POLAND

Co Author(s):    M. Mimier - Janczak   M. Pomorska   M. Misiuk Hojlo              

Abstract Details

Purpose:

The given poster presents the case of the 36 years old women, who was operated on cataractin both eyes few months after giving birth. She noticed the visual acuity deprivation during her pregnancy. The pregnancy was the result of the IVF - in vitro fertilization, before which the patient needed to undergo proper hormonal stimulation, influencing the ovarian functioning - including estrogen secretion. Therefore we want to confirm connection between hormonal changes and possible cataract development in women's eyes.

Setting:

36 yo woman was admitted for ophthalmological qualification for cataract surgery. She noticed the visual acuity deprivation during her pregnancy. Bilateral cataract was diagnosed. She had no predispositions to develop catarct in such young age - no history of chronic diseases, no drugs administered, no ophthalmological diseases in the past.

Report of Case:

The patient was qualified for cataract surgery in both eyes. In the ophthalmological examination the visual acuity in both eyes was 0.5, intraocular pressures were within normal limits. The anterior segment did not show any abnormalities, except for subcapsular cataract in both eyes. The fundus of the eye bilaterally was witihin normal limits. Few months before the qualification visit the patient gave birth to her first child. The pregnancy was the result of the IVF - in vitro fertilization. Before the IVF procedure, the patient was hormonally stimulated, according to the commonly used and certified protocol. During one of the stages, the patient was given the GnRH analogues. They are being used in the 'ovarian suppression' stage, where the ovaries are being suppressed for some period of time - therefore the hormone estrogen, is not being secreted. This hormone has been proven to be important in the lens protection against cataract (Estrogen Protects Lenses against Cataract Induced by Transforming Growth Factor-β (TGFβ), Angela M. Hales, Coral G. Chamberlain, Christopher R. Murphy, and John W. McAvoy, J Exp Med. 1997 Jan 20; 185(2): 273–280.).

Conclusion/Take Home Message:

We presented this case in order to put pressure on the topic and to explore it more in the future. Unfortunately, we can not exclude the incidental factor in this case - the patient could develop cataract without any predisposition. Nevertheless, considering the most often used IVF protocols of hormones stimulation, they result in suppressing the pituitary gland in excreting estrogen and its final result on the lens, we found it interesting how it could affect our patient's state.

Financial Disclosure:

None