Abstract

Ovarian hyperstimulation syndrome (OHSS) is a relatively common complication in infertile patients treated with exogenous gonadotropins. Ovarian hyperstimulation in spontaneous pregnancies is a rare but possible. The pathogenesis of spontaneous OHSS is not well known. Risk factors for OHSS are young age, polycystic ovaries, low body mass index, high gonadotropin dose, increased estradiol and human chorionic gonadotropin levels, multiple pregnancy, OHSS history, molar pregnancy and hypothyroidism. In this report we present a case of severe spontaneous OHSS with a brief summary of the literature. She was hospitalized and treated in the clinic with the diagnosis of severe OHSS accompanying spontaneous pregnancy.

Highlights

  • Ovarian hyperstimulation syndrome is a relatively common iatrogenic complication of ovulation induction and controlled ovarian hyperstimulation induced with exogenous gonadotropins.[1]

  • The patient was hospitalized with the diagnosis of severe spontaneous Ovarian hyperstimulation syndrome (OHSS) and treated with intravenous fluid replacement, albumin infusion, and low molecular weight heparin

  • Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication of exogenous gonadotropins or sometimes clomiphene citrate used for ovulation induction.[4]

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Summary

Introduction

Ovarian hyperstimulation syndrome is a relatively common iatrogenic complication of ovulation induction and controlled ovarian hyperstimulation induced with exogenous gonadotropins.[1]. A 27 year-old gravida 3 para 2 woman presented to the clinic with a complaint of abdominal pain, abdominal distension, dyspnea, nausea and vomiting. Abdominal distension and bilateral adnexal pain were noted during the physical examination Transabdominal ultrasonography revealed a 10-week, singleton pregnancy. Both of the ovaries were enlarged and multicystic (Left ovary: 118 x 113 mm, right ovary: 127 x 117) and there were ascites in the abdomen. The patient was hospitalized with the diagnosis of severe spontaneous OHSS and treated with intravenous fluid replacement, albumin infusion, and low molecular weight heparin. After four weeks of treatment abdominal distension and dyspnea were dissolved and laboratory tests were normalized. She was seen at regular visits and delivered uneventfully at the 37th week of pregnancy

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