No abstract

These results suggest that elevated alpha(2)M levels are associated with a decreased risk of developing OHSS. alpha(2)M may act by 'removing and inactivating' VEGF, with higher levels providing increased protection against the syndrome. alpha(2)M measurements may help to differentiate those for whom it is safe to proceed with embryo transfer from those for whom it is not, because of the risk of OHSS.

No abstract

The ovarian hyperstimulation syndrome (OHSS) remains one of the enigmas of reproductive medicine. We all fear its development in our patients and we all have “pet” policies for its prevention and treatment. Despite this, its incidence has not changed significantly in the last 20 years with the severe form still occurring in 0.3–5.0% of cycles. Its pathogenesis clearly has a physiological basis but it would appear to be compounded by the body's homeostatic response to the changes produced by the syndrome.

This is a case report of a primigravida who was noticed to have a large pelvic mass at the time of her "booking" scan. A magnetic resonance imaging (MRI) scan was performed in order to elucidate the exact nature of the mass, which enlarged between successive scans. The appearances were in keeping with a leiomyoma undergoing degenerative change. The patient underwent a laparotomy in pregnancy to remove the leiomyoma, which was found to contain fluid-filled cavities. The uterine cavity was not breached at the time of surgery. The pregnancy continued uneventfully until term, and the baby was delivered by caesarean section. The postnatal period was uneventful.