Abstract
Isolated unilateral pleural effusion is uncommon presentation of ovarian hyperstimulation syndrome. The pathogenesis of this syndrome involves an increased permeability of ovarian capillaries and mesothelial vessels triggered by the release of vasoactive substances by the ovaries under human chorionic gonadotropin stimulation. Physicians should consider this potentially life-threatening diagnosis in all patients who undergo ovarian hyperstimulation. This case highlights a rare clinical manifestation of isolated hemorrhagic pleural effusion associated with ovarian hyperstimulation.
Highlights
Pharmacological ovarian stimulation, a well established therapeutic procedure in the field of infertility, has been widely used in the last decade
(1) Symptoms range from mild abdominal pain, diarrhea and nausea to severe disease characterized by ascites, rapid weight gain, hemodynamic instability, tachypnea and oliguria
Due to the increased use of therapeutic strategies for infertility, the pulmonary complication of this syndrome should be suspected on clinical grounds and identified early to allow more appropriate diagnosis and management
Summary
Pharmacological ovarian stimulation, a well established therapeutic procedure in the field of infertility, has been widely used in the last decade. Five days after oocyte retrieval, she presented to our emergency department with progressive shortness of breath, associated with lower abdominal pain and nausea. On physical examination, her heart rate was 110 beat/min, blood pressure 100/70 mm Hg and O2 saturation 90% breathing room air. Culture and acid fast stain were negative Doppler ultrasonography of both legs showed no evidence of deep vein thrombosis. She was labeled to have pleural effusion due to OHSS after excluding all the secondary causes. She was treated symptomatically with intravenous fluids and supportive care.
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