Ovarian Hyperstimulation Syndrome as a Growing Diagnostic Problem in Emergency Department Settings: A Case Report

J Emerg Med. 2019 Feb;56(2):217-221. doi: 10.1016/j.jemermed.2018.11.004. Epub 2018 Dec 14.

Abstract

Background: Ovarian hyperstimulation syndrome (OHSS) is a common complication of an in-vitro fertilization (IVF) procedure, which is usually clinically insignificant. However, without monitoring, it can progress into a life-threatening condition. With the increasing popularity of IVF technology, patients with OHSS may begin visiting emergency departments (EDs) more frequently.

Case report: We report the case of a patient admitted to the ED presenting with severe abdominal pain, cough, and nausea. An ultrasound examination was inconclusive. Computer tomography revealed enlarged ovaries and fluid in the pleural cavities, around the liver and spleen, between the bowel loops, and in the pelvis. This prompted physicians to review the patient's fertility issues. Consequently, the diagnosis of OHSS was made. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: When the physician knows that the patient is undergoing IVF, the diagnosis of OHSS can be straightforward; without this information, it can be difficult. Having in mind the growing demand for infertility treatment, we present this case to increase awareness of possible clinical findings and complications of OHSS as a rare consequence of IVF. OHSS diagnosed via ultrasound can reduce the emotional, financial, and health burden of infertile couples and help them to fulfill their procreation plans without unnecessary delay.

Keywords: IVF; ovarian hyperstimulation syndrome.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / diagnostic imaging
  • Abdominal Pain / etiology
  • Adult
  • Cough / etiology
  • Emergency Service, Hospital / organization & administration
  • Female
  • Fertilization in Vitro / adverse effects*
  • Fertilization in Vitro / methods
  • Humans
  • Infertility / therapy
  • Nausea / etiology
  • Ovarian Hyperstimulation Syndrome / diagnosis*
  • Ovarian Hyperstimulation Syndrome / physiopathology
  • Tomography, X-Ray Computed / methods