Clinical Report: Uncommon Spontaneous Ovarian Hyperstimulation Syndrome with Liver Complications

Background

Ovarian hyperstimulation syndrome (OHSS) is primarily an iatrogenic condition associated with assisted reproductive techniques, yet spontaneous cases are rare. Understanding spontaneous OHSS, particularly with atypical manifestations such as hepatic involvement, is crucial for timely diagnosis and management. The relationship between spontaneous OHSS and liver complications remains poorly understood, necessitating further investigation.

Data Highlights

Clinical findings from the cases include abdominal distension, ascites, hyperbilirubinemia, and elevated liver enzymes, with imaging revealing enlarged ovaries.

Key Findings

• Spontaneous OHSS can occur in early singleton pregnancies without prior assisted reproductive techniques.
• Case 1 involved a 21-year-old woman with abdominal distension, ascites, and hyperbilirubinemia, revealing enlarged ovaries and biliary findings.
• Case 2 involved a 23-year-old woman with abdominal pain, bilious vomiting, and elevated liver enzymes, also showing bilateral ovarian enlargement.
• Both cases were diagnosed based on clinical and imaging findings after excluding other causes.
• Management was conservative, with one patient requiring laparoscopic cholecystectomy for symptomatic biliary disease.

Clinical Implications

Healthcare professionals should consider spontaneous OHSS in pregnant patients presenting with abdominal symptoms and abnormal liver function tests.

Conclusion

These cases illustrate the occurrence of spontaneous OHSS in pregnancy with hepatic involvement.

Related Resources & Content

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2. Frontiers in Endocrinology — Successful ovulation and pregnancy with pulsatile GnRH pump therapy in a polycystic ovary syndrome (PCOS) patient: a case report
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5. The Journal of Clinical Endocrinology & Metabolism — Elevated AMH Levels Correlate With Gestational Hypertension in PCOS Patients Undergoing IVF/ICSI with Fresh Embryo Transfer
6. Prevention of moderate and severe ovarian hyperstimulation syndrome: a guideline
7. Are the various treatments used to stimulate the ovaries in women undergoing in vitro fertilisation (IVF) effective and safe? | Cochrane
8. Frontiers | Spontaneous ovarian hyperstimulation syndrome in early singleton pregnancy with hepatic involvement: two case reports of atypical presentations