scholarly journals Spontaneous Pregnancy with Severe Ovarian Hyperstimulation Syndrome Undergoing IVF-ET Cycle: A Case Report and Review

2020 ◽  
Author(s):  
Chaonan Peng ◽  
Zhixiao Wang
Keyword(s):  
Embryo Transfer ◽  
Ovarian Hyperstimulation Syndrome ◽  
Induction Treatment ◽  
Ovarian Hyperstimulation ◽  
Self Healing ◽  
Spontaneous Pregnancy ◽  
Severe Ovarian Hyperstimulation Syndrome ◽  
Severe Ohss ◽  
Ivf Et

Abstract It is relatively rare that a natural spontaneous with severe ovarian hyperstimulation syndrome (OHSS) occurs undergoing in vitro fertilization and embryo transfer (IVF-ET).Pregnancy can cause OHSS to be delayed, and even lead to pregnancy loss in severe cases.In this case, we introduced the case of a 32-year-old female infertile patient with PCOS who underwent IVF-ET cycle and developed severe OHSS before embryo transfer. After volume expansion, symptomatic and supportive treatment and four times of abdominal puncture to extract ascites, the patient's condition is still protracted.However, interestingly, two weeks after giving up treatment, the patient found a spontaneous pregnancy and ended up with biochemical pregnancy. Severe OHSS was also gradually self-healing after biochemical pregnancy.This case emphasizes that pregnancy is one of the high-risk factors of OHSS, which can lead to the delay of the patient's condition with OHSS. Clinicians should be alert to the possibility of spontaneous pregnancy when they take luteal phase ovulation induction treatment undergoing IVF-ET cycle.

scholarly journals Prediction of severe ovarian hyperstimulation syndrome in women undergoing in vitro fertilization using estradiol levels, collected ova, and number of follicles

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094555
Author(s):  
Ivan Madrazo ◽  
Monserrat Fabiola Vélez ◽  
Josue Jonathan Hidalgo ◽  
Ginna Ortiz ◽  
Juan José Suárez ◽  
...  
Keyword(s):  
Ovarian Hyperstimulation Syndrome ◽  
Characteristic Curve ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Ovarian Hyperstimulation ◽  
Vitro Fertilization ◽  
American Society ◽  
Severe Ovarian Hyperstimulation Syndrome ◽  
Severe Ohss

Objective Our objective was to determine whether estradiol (E2) levels (Day 3 and fold change to Day 10), antral follicle count (AFC), and number of ova collected could predict ovarian hyperstimulation syndrome (OHSS) and culdocentesis intervention. Methods We conducted a retrospective review of patient charts between January 2008 and December 2017. OHSS was defined using American Society for Reproductive Medicine criteria. Predictability was evaluated by measuring the area under the receiver operating characteristic curve (AUC). Results The cohort included 319 women (166 controls, 153 OHSS, of whom 54 had severe OHSS). The OHSS group had higher E2Day 3 (249 ± 177 vs. 150 ± 230 ng/L), E2FoldChange (32.2 ± 29.1 vs. 20.1 ± 23.8), AFC (18.2 ± 9.1 vs. 11.6 ± 8.3), and number of ova collected (21.1 ± 9.0 vs. 10.1 ± 6.5). E2Day 3 (AUC = 0.76, 95%CI: 0.71–0.82), E2FoldChange (AUC = 0.71, 95%CI: 0.65–0.77), AFC (AUC = 0.75, 95%CI: 0.70–0.81), and number of ova collected (AUC = 0.85, 95%CI: 0.81–0.89) were predictive for OHSS. All variables were predictive for culdocentesis intervention (E2Day 3: AUC = 0.63, 95%CI: 0.55–0.70; E2FoldChange: AUC = 0.63, 95%CI: 0.55–0.71; AFC: AUC = 0.74, 95%CI: 0.68–0.80; number of ova collected: AUC = 0.80, 95%CI: 0.75–0.85). Conclusions Day 3 E2 levels and number of ova collected predict patients who could develop OHSS and may require culdocentesis.

scholarly journals Follicle-Stimulating Hormone-Secreting Pituitary Adenoma Inducing Spontaneous Ovarian Hyperstimulation Syndrome, Treatment Using In Vitro Fertilization and Embryo Transfer: A Case Report

2021 ◽  
Vol 12 ◽  
Author(s):  
Xiaofang Du ◽  
Wen Zhang ◽  
Xingling Wang ◽  
Xiaona Yu ◽  
Zhen Li ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Embryo Transfer ◽  
Ovarian Hyperstimulation Syndrome ◽  
Therapeutic Option ◽  
Follicle Stimulating Hormone ◽  
Reproductive Age ◽  
Ovarian Hyperstimulation ◽  
Ivf Et ◽  
Stimulating Hormone

ObjectiveTo describe the management of a patient with a pituitary adenoma secreting follicle-stimulating hormone (FSH) associated with spontaneous ovarian hyperstimulation syndrome (sOHSS) who was treated with in vitro fertilization and embryo transfer (IVF-ET).MethodsWe report a clinical case of a woman of reproductive age with menstrual irregularity, infertility and ovarian hyperstimulation due to recurrent pituitary adenoma secreting FSH, which persisted after transsphenoidal surgery.She underwent the diagnosis by magnetic resonance imaging (MRI) and laboratory tests,and finally she was treated with IVF-ET.Result(s)The patient was plagued by a recurrent pituitary adenoma for many years and tried various treatments. After complete transsphenoidal surgery, sOHSS decreased, as shown by a reduction in oestradiol levels and an improvement in the ultrasonography parameters; however, secondary amenorrhea occurred. Finally, pregnancy was achieved through IVF-ET and the symptoms of ovarian hyperstimulation were relieved.Conclusion(s)IVF-ET was found to be effective for the treatment of recurrent pituitary adenoma, thus representing a therapeutic option that should be taken into consideration in such cases.

Severe ovarian hyperstimulation syndrome with GnRH agonist trigger during the COVID pandemic: lessons learned from an unusual case

2021 ◽  
Vol 5 (04) ◽  
pp. 01-04
Author(s):  
Bradley S Hurst ◽  
Evan Schrader ◽  
Tanner Hurley ◽  
Lariena Welch ◽  
Ying Ying ◽  
...  
Keyword(s):  
Gnrh Agonist ◽  
Ovarian Hyperstimulation Syndrome ◽  
Unusual Case ◽  
Oocyte Retrieval ◽  
Lessons Learned ◽  
Ovarian Hyperstimulation ◽  
Gnrh Agonist Trigger ◽  
Severe Ovarian Hyperstimulation Syndrome ◽  
Agonist Trigger ◽  
Severe Ohss

Background: Injectable gonadotropins stimulate multi-follicular recruitment and allows retrieval of multiple oocytes for assisted reproduction. The widespread utilization of gonadotropin releasing hormone agonist (GnRHa) to induce oocyte maturation for oocyte retrieval has nearly eliminated the risk of severe ovarian hyperstimulation syndrome (OHSS), and only a few cases have been reported in the literature. The rarity of severe OHSS may lead to the mistaken conclusion that gonadotropin stimulation can be safely administered with limited monitoring, even in high-risk patients. We present an unusual case of a woman with limited monitoring due to the COVID pandemic who developed severe OHSS before GnRH agonist trigger and oocyte. Case Presentation: A 29-year-old nulliparous woman with polycystic ovarian syndrome (PCOS) initiated ovarian stimulation for oocyte retrieval. She had a robust initial response, and developed worsening abdominal pain, bloating, nausea, vomiting, and decreased appetite before retrieval. GnRH agonist was given to “trigger ovulation and retrieval scheduled due to the low reported incidence of severe OHSS. Symptoms progressed, and on the morning of retrieval, ultrasound demonstrated bilaterally enlarged ovaries >10cm and 48 oocytes were retrieved for a planned cryo-all cycle. She was hospitalized on the day of retrieval for severe OHSS and had two large-volume paracenteses. She was stable and discharged home by day 5, and symptoms markedly improved with the onset of menses. She has an ongoing pregnancy from her first frozen embryo transfer. Conclusion: We add a rare case of severe OHSS with a GnRHa trigger and cryo-all protocol with the onset of symptoms before GnRH agonist administration. Although rare, severe OHSS may still occur with a GnRHa trigger, and caution is needed when an initial robust response is identified. Here we also provide an opportunity to review the important patient risk factors for the development of OHSS and measures to reduce the risk in excessive responders.

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