Radiological Illustration of Spontaneous Ovarian Hyperstimulation Syndrome

Thakkar, Hemangini

doi:10.12659/pjr.893536

Cited by 21 publications

(5 citation statements)

References 38 publications

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“…Type IV is related to gonadotrophin adenomas secreting FSH or LH. In recent years, studies have found that FSHR gene mutations can be activated not only by FSH, but also by the glycoprotein hormones having the same β subunit[14] such as TSH, LH, and HCG, increasing its sensitivity to HCG produced during natural pregnancy and leading to the occurrence of OHSS during natural pregnancy, and this kind of sOHSS has familial disposition and recurrent characteristics[15]. Alternative theories might include the presence of variant HCG or variant TSH that exhibits higher biological activity or granulosa cells in an autocrine environment that is more sensitive to FSHR stimulation.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous ovarian hyperstimulation syndrome: Report of two cases

Gui

Zhang

et al. 2019

WJCC

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BACKGROUNDSpontaneous ovarian hyperstimulation syndrome (sOHSS) is extremely rare. It can be divided into four types according to its clinical manifestations and follicle stimulating hormone receptor mutations.CASE SUMMARYHere we report two cases of sOHSS in Chinese women, one with a singleton gestation developing sOHSS in the first trimester who conceived naturally and the other with a twin pregnancy developing sOHSS in the second trimester after a thawed embryo transfer cycle. Both patients were admitted to the hospital with abdominal distension, ascites, and enlarged ovaries. Conservative treatment was the primary option of management. The first patient had spontaneous onset labor at 40 wk of gestation and underwent an uncomplicated vaginal delivery of a male newborn. The second patient delivered a female baby and a male baby by caesarean section at 35 wk and 1 d of gestation.CONCLUSIONPatients with a history of ovarian hyperstimulation syndrome should be closely monitored. Single embryo transfer might reduce the risk of this rare syndrome.

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Section: Discussionmentioning

confidence: 99%

Spontaneous ovarian hyperstimulation syndrome: Report of two cases

Gui

Zhang

et al. 2019

WJCC

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“…In this case, the treatment of OHSS is conservative and should be defined according to the severity of clinical signs, blood clinical parameters and radiological examinations [ 56 ]. The main medical and surgical treatment were extensively described previously [ 54 , 55 , 57 – 60 ]. Recently, it has been also proposed that the therapeutic principles for OHSS should be consistent with those of the intra-abdominal hypertension syndrome therapy, but further research is needed in this field [ 61 ].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous and iatrogenic ovarian hyperstimulation syndrome in the absence of FSHR mutations: a case report of two unexpected cases

et al. 2023

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Background Ovarian hyperstimulation syndrome (OHSS) is a complication of controlled ovarian hyperstimulation (COH). It is a potentially life-threatening condition that usually occurs either after human chorionic gonadotropins (hCG) administration in susceptible patients or as a result of an implanting pregnancy, regardless of whether it was achieved by natural conception or infertility treatments. Despite many years of clinical experience regarding the adoption of preventive measures and the identification of patients at high risk, the pathophysiology of OHSS is poorly understood and no reliable predictive risk factors have been identified. Cases presentation We report about two unexpected cases of OHSS following infertility treatments, occurring after freeze-all strategy with embryo cryopreservation approaches. The first case developed spontaneous OHSS (sOHSS), despite efforts to prevent its manifestation by a segmentation approach, including frozen embryo replacement cycle. The second case developed a late form of iatrogenic OHSS (iOHSS), even though the absence of any risk factors. No mutations in the follicle-stimulating hormone (FSH) receptor (FSHR)-encoding gene were detected, suggesting that the high levels of hCG due to the twin implanting pregnancies could be the only triggering factor of OHSS outbreak. Conclusion Freeze-all strategy with embryo cryopreservation cannot entirely prevent the development of OHSS, which may occur in its spontaneous form independently from the FSHR genotype. Although OHSS remains a rare event, all infertile patients requiring ovulation induction or controlled ovarian stimulation (COS) may be at potential risk of OHSS, either in the presence or in the absence of risk factors. We suggest closely monitoring cases of pregnancy following infertility treatments in order to provide early diagnosis and adopt the conservative management.

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“…In literature, non- iatrogenic OHSS has been described in pregnancy (especially multiple), gestational trophoblastic disease, b-hCG - secreting tumors, FSH/LH-secreting pituitary adenomas, and high levels of TSH in hypothyroidism [31 , 32] . The OHSS is characterized by the combination of massive ovarian multicystic masses and potential complication due to increased vascular permeability induced by high hormonal level [33] . This syndrome's pathogenesis is still poorly understood.…”

Section: Discussionmentioning

confidence: 99%

Metastatic choriocarcinoma with hemorrhagic complications and spontaneous ovarian hyperstimulation syndrome: A case report

Lucia

Castaldo

D'Agostino

et al. 2021

Radiology Case Reports

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Gestational choriocarcinoma is a malignant trophoblastic tumor arising from any gestational event, even with a long latency period, generally in the reproductive female. It is associated with a high level of beta-human chorionic gonadotropin. Its primary site is usually the uterus but not all patients have a detectable lesion in this site. Regression of the primary tumor after it has metastasized is not uncommon, and one-third of cases manifest as complications of metastatic disease. In this report we present an uncommon case of gestational choriocarcinoma with lung, liver and jejunal metastases at the time of diagnosis without evidence of pelvic disease, in 34-year-old woman. The main points of interest of our case were the development of the ovarian hyperstimulation syndrome with massive multicystic ovarian enlargement induced by high level of beta-human chorionic gonadotropin and the bleeding of jejunal and liver metastases, due to the high vascularity of the tumor tissue, a condition known as “Choriocarcinoma Syndrome”. We will focus on the radiological findings of metastases, bleeding complications and ovarian hyperstimulation syndrome.

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Radiological Illustration of Spontaneous Ovarian Hyperstimulation Syndrome

Cited by 21 publications

References 38 publications

Spontaneous ovarian hyperstimulation syndrome: Report of two cases

Spontaneous ovarian hyperstimulation syndrome: Report of two cases

Spontaneous and iatrogenic ovarian hyperstimulation syndrome in the absence of FSHR mutations: a case report of two unexpected cases

Metastatic choriocarcinoma with hemorrhagic complications and spontaneous ovarian hyperstimulation syndrome: A case report

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