Ovarian hyperstimulation syndrome following ovum pick-up procedure: A case study

Advances in assisted reproduction technologies (ARTs) have increasingly allowed infertile women to access such treatment modalities. As controlled ovarian hyperstimulation (COH) is a routine protocol to generate a sufficient number of follicles during in vitro fertilization, a possible ramification of this is the development of ovarian hyperstimulation syndrome (OHSS). It is the most serious complication of iatrogenic COH mediated by excessive secretion of vasoactive mediators, which in turn increases vascular permeability resulting in intravascular fluid shift into the third spaces. In this report, we describe a case of a 36-year-old woman with primary infertility who developed moderate OHSS 2 days after undergoing a scheduled ovum pick. She presented with progressive abdominal distension, diffuse abdominal pain, and worsening nausea and vomiting. Laboratory investigations showed leukocytosis, erythrocytosis, hypoalbuminemia, and decreased activated partial thromboplastin time. Imaging studies revealed bilaterally enlarged ovaries, ascites, and bilateral lung atelectasis. OHSS was suspected and was managed with adequate analgesics, anticoagulants, albumin infusion, and paracentesis. The patient recuperated and was discharged on the day 3 of admission. This case report emphasizes the importance of early recognition and management of OHSS to optimize patient outcomes. Given the increasing use of ART, physicians should be vigilant about OHSS as its potential complication and develop appropriate preventive, diagnostic, and therapeutic strategies.