scholarly journals Severe Ovarian Hyperstimulation Syndrome in a Woman With Breast Cancer Under Letrozole Triggered With GnRH Agonist: A Case Report and Review of the Literature

2021 ◽  
Vol 3 ◽  
Author(s):  
Giuseppe Gabriele Iorio ◽  
Marika Ylenia Rovetto ◽  
Alessandro Conforti ◽  
Luigi Carbone ◽  
Roberta Vallone ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Ovarian Hyperstimulation Syndrome ◽  
Polycystic Ovary ◽  
Complete Recovery ◽  
Human Albumin ◽  
Ovarian Hyperstimulation ◽  
Risk Patients ◽  
History Of ◽  
Ovarian Syndrome ◽  
Severe Ovarian Hyperstimulation Syndrome

We report a rare case of ovarian hyperstimulation syndrome (OHSS) in a 28-year-old woman with breast cancer and with a history of polycystic ovary syndrome (PCOS) despite treatment with letrozole and gonadotropin-releasing hormone agonist (GnRH-a) triggering in a GnRH antagonist (GnRH-ant) protocol without the administration of any human chorionic gonadotropin (hCG) for luteal-phase support. The patient, who underwent controlled ovarian syndrome (COS)-oocyte cryopreservation before chemotherapy, required hospitalization. Complete recovery was achieved after treatment with volume expanders, human albumin, and cabergoline. Based on our case and literature review, it is possible to establish that estradiol (E2) modulation with letrozole and GnRH-a triggering does not eliminate the risk of OHSS. Furthermore, it is advisable to postpone GnRH-a depot to minimize the risk of OHSS after the suspension of letrozole, following menstruation or at least 7–8 days after triggering. It would be desirable to identify high-risk patients, also on a genetic basis, in order to avoid delays in oncologic treatments that could strongly impact life expectancy.

scholarly journals Severe Ovarian Hyperstimulation Syndrome despite low dose stimulation in Polycystic Ovarian Syndrome

2019 ◽  
Vol 10 (3) ◽  
pp. 50-53
Author(s):  
Robin George Manappallil ◽  
Sivadas Vilakupadath Kokoori ◽  
Nandini Valsala
Keyword(s):  
Ovarian Hyperstimulation Syndrome ◽  
Low Dose ◽  
Polycystic Ovary ◽  
Ovarian Hyperstimulation ◽  
Fluid Shift ◽  
Ovary Syndrome ◽  
Assisted Reproduction Technology ◽  
Ovarian Syndrome ◽  
Severe Ovarian Hyperstimulation Syndrome ◽  
Severe Ohss

Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication of assisted reproduction technology. There is cystic enlargement of the ovaries along with fluid shift from the intravascular compartment to the third space due to increased capillary permeability and ovarian neoangiogenesis. Severe OHSS is uncommon and the condition can be fatal. Low-dose gonadotropin protocols have been introduced to reduce the risk of OHSS in patients with polycystic ovary syndrome (PCOS). The patient being reported had PCOS and developed severe OHSS despite low dose gonadotropin stimulation; which is a rare scenario.

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