Inquest told woman knew of treatment risks

A 32-year-old woman who developed an 80 per cent risk of contracting a potentially fatal condition during fertility treatment at the Rotunda Hospital in Dublin was allowed to continue with the treatment, an inquest into her death heard yesterday.

Ms Jacqueline Rushton began IVF treatment in late 2002 at the Rotunda's human assisted reproduction unit. She died in January 2003 from adult respiratory distress syndrome, a rare complication of a condition known as ovarian hyperstimulation, the Dublin Coroner's Court heard.

The head of obstetrics at the Rotunda, Prof Robert Harrison, told Dublin City Coroner, Dr Brian Farrell, that Ms Rushton and her husband had been given an information booklet and shown a video which set out all the possible complications of IVF, including ovarian hyperstimulation syndrome (OHSS).

The condition can occur during IVF as the treatment involves stimulating the ovaries to produce more eggs than normal.

Ms Rushton, who had an ovulation problem, was given a drug called Recombinant FSH (Puregon) to stimulate her ovaries to produce eggs on November 26th, 2002, Prof Harrison said.

A scan on December 2nd showed Ms Rushton had an "overreaction to the treatment", he said, and was suffering some abdominal "discomfort".

The overreaction meant Ms Rushton had produced more ovarian follicles than expected and had an oestrogen level three times higher than the desirable upper level. These, Prof Harrison said, were "warning signs" for OHSS.

Ms Rushton was advised of the danger of developing the condition and was given the choice to stop the treatment, he said. However, she opted to continue with it.

On December 8th, 33 eggs - a higher number than normal - were harvested from Ms Rushton. After this collection she felt sick and was advised to have the eggs frozen, which she did. She was admitted to the Rotunda for continuing observation.

Two days later she developed mild OHSS, and two days after that she was transferred to the high dependency unit at the hospital. On the December 16th it was "felt more appropriate" to transfer her to the Mater hospital, Prof Rushton said.

At the Mater she developed severe OHSS. After a week she appeared to make a recovery but then collapsed and was put on a ventilator. It was switched off on January 14th, 2003, resulting in her death.

The inquest adjourned to April.