Ovarian Hyperstimulation Syndrome with pleural effusion: a case report (original) (raw)
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Compressive pleural effusion after ovarian hyperstimulation syndrome--a case report and review
Fertility and …, 2008
Objective: To report a case of early onset ovarian hyperstimulation with massive pleural effusion and respiratory failure before IVF. Design: Case report. Setting: University teaching intensive care unit. Patient(s): A 26-year-old healthy woman with an unexplained infertility transferred to the intensive care unit on day 4 after hCG injection for early severe presentation of ovarian hyperstimulation syndrome with massive compressive pleural effusion before she underwent embryo transfer. Intervention(s): Mechanical ventilation, thoracocentesis. Main Outcome Measure(s): Resolution of symptoms/stopping of embryos transfer. Result(s): Drainage of 5,300 mL of sterile exudative pleural fluid for a period of 48 hours, which permitted resolution of symptoms and allowed mechanical weaning. The IVF procedure was stopped. Conclusion(s): This case described is unusual in that the patient presented with early massive pleural effusion on day 4 after hCG injection and before embryo transfer. This is much earlier than in any case report elsewhere. (Fertil Steril Ò 2008;89:1826.e1-3.
Pleural effusion following ovarian hyperstimulation
2012
Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication that occurs in the luteal phase of an induced hormonal cycle. In most cases, the symptoms are self-limited and spontaneous regression occurs. However, severe cases are typically accompanied by acute respiratory distress. The objective of the present study was to describe the clinical presentation, treatment, and outcome of pleural effusion associated with OHSS in three patients undergoing in vitro fertilization. The patients ranged in age from 27 to 33 years. The onset of symptomatic pleural effusion (bilateral in all cases) occurred, on average, 43 days (range, 27-60 days) after initiation of hormone therapy for ovulation induction. All three patients required hospitalization for massive fluid resuscitation, and two required noninvasive mechanical ventilation. Although all three patients initially underwent thoracentesis, early recurrence of symptoms and pleural effusion prompted the use of drainage with a pigta...
Case reports in obstetrics and gynecology, 2011
Ovarian hyperstimulation syndrome (OHSS) presents in ~33% of ovarian stimulation cycles with clinical manifestations varying from mild to severe. Its pathogenesis is unknown. Pleural effusion is reported in ~10% of severe OHSS cases and is usually associated with marked ascites. The isolated finding of pleural effusions without ascites, as the main presenting symptom of OHSS is not frequently reported and its pathogenesis is also unknown. We describe two unusual cases of OHSS where dyspnea secondary to unilateral pleural effusion was the only presenting symptom. By reporting our experience, we would like to heighten physicians' awareness in detecting these cases early, as it is our belief that the incidence of pleural effusion in the absence of most commonly recognized risk factors for OHSS may be underestimated and may significantly compromise the health of the patient if treatment is not initiated in a reasonable amount of time.
Ovarian Hyperstimulation Syndrome: A Rare Case of Unilateral Pleural Effusion
Journal of emergency medicine case reports, 2016
Introduction: Ovarian hyperstimulation syndrome (OHSS) is a rare, usually self-limiting, life-threatening iatrogenic complication. Pleural effusion is usually bilateral and seen in severe forms. Unilateral pleural effusion in OHSS is extremely rare. Here, we present a patient with unilateral pleural effusion due to OHSS. Case Report: A 30-year-old woman with a history of infertility for 5 years and no significant past medical history or physical findings applied to an in vitro fertilization (IVF) center. Ovarian stimulation was initiated. She was admitted with complaints of dyspnea on the second day that she was β-human chorionic gonadotropin (β-hCG)-positive. She had tachypnea and decreased breath sounds. All laboratory tests were within the normal range. Ultrasonography evaluation demonstrated right pleural effusion without intraperitoneal fluid. Thoracentesis was performed, and 3000 cc exudative fluid was drained. Conclusion: The number of patients who undergo infertility treatment at IVF centers has been increasing. Although OHSS is considered as if it is a syndrome that belongs to gynecology and obstetrics clinics or IVF units, the chances of clinicians who work in the emergency service and thoracic diseases and thoracic surgery centers encountering these patients have increased. Therefore, it should be kept in mind that there may be unilateral pleural effusion without peritoneal fluid in OHSS.
Symptomatic Unilateral Pleural Effusion Secondary due to Ovarian Hyperstimulation Syndrome
The Indian journal of chest diseases & allied sciences, 2016
Isolated pleural effusion is a rare presentation of ovarian hyperstimulation syndrome following ovulation induction therapy. We hereby report the case of a 24-year-old female who presented with unilateral moderate pleural effusion following ovulation induction therapy. Therapeutic thoracentesis was performed to relieve the breathlessness in this case.
Ovarian hyperstimulation syndrome and pulmonary edema – a rare complication
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2017
Background: Ovarian Hyperstimulation Syndrome (OHSS) is a life-threatening complication of controlled ovarian stimulation almost exclusively associated with gonadotropins but occasionally with clomiphene citrate. Prevention of this syndrome lies in the recognition of risk factors and individualizing the treatment regimens. Causes of respiratory distress in patients with OHSS are pleural effusion, pulmonary embolism, and acute respiratory distress syndrome (ARDS). Pulmonary edema is rare but a grave complication of OHSS.Case report: We report, a case of severe OHSS with tense ascites and anasarca after controlled ovarian hyperstimulation (COH) for IVF. She was managed conservatively followed by paracentesis after which she developed pulmonary edema during the course of the treatment.Conclusion: OHSS is an iatrogenic complication which can be prevented by individualizing stimulation protocols and should be managed urgently with a multidisciplinary approach.
Severe ovarian hyperstimulation syndrome leading to ICU admission
Saudi Journal of …, 2010
Severe ovarian hyperstimulation is a rare complication of ovulation induction therapy. In this report, we are presenting a case of 33-year female, who required intensive care unit admission due to respiratory failure secondary to massive pleural effusion and ascites. With the positive history of in vitro fertilization, the patient was diagnosed to have severe ovarian hyperstimulation syndrome. Besides the medical treatment, abdominal paracentesis for the drainage of massive ascites and tube thoracostomy were performed, resulting in gradual improvement.
Pulmonary manifestations of severe ovarian hyperstimulation syndrome: a multicenter study
Fertility and Sterility, 1999
Objective: To assess the pulmonary manifestations of severe ovarian hyperstimulation syndrome (OHSS). Design: A retrospective nationwide 10-year multicenter study. Setting: Sixteen of 19 tertiary medical centers in Israel. Patient(s): All patients hospitalized at these centers for severe OHSS between January 1987 and December 1996. Main Outcome Measure(s): Clinical presentation, arterial blood gases on room air, and chest roentgenogram results.
Acute respiratory failure following ovarian hyperstimulation syndrome
Italian Journal of Medicine, 2013
Ovarian hyperstimulation syndrome is a serious and potentially life-threatening physiological complication that may be encountered in patients who undergo controlled ovarian hyperstimulation cycles. The syndrome is typically associated with regimes of exogenous gonadotropins, but it can be seen, albeit rarely, when clomiphene is administered during the induction phase. Although this syndrome is widely described in scientific literature and is well known by obstetricians, the knowledge of this pathological and potentially life-threatening condition is generally less than satisfactory among physicians. The dramatic increase in therapeutic strategies to treat infertility has pushed this condition into the realm of acute care therapy. The potential complications of this syndrome, including pulmonary involvement, should be considered and identified so as to allow a more appropriate diagnosis and management. We describe a case of a woman with an extremely severe (Stage 6) ovarian hypersti...