CASE REPORT: Ovarian Hyperstimulation Syndrome Complicating a Spontaneous Singleton Pregnancy: A Case Report

University of Ulsan, Asan Medical Center
Journal of Assisted Reproduction and Genetics (Impact Factor: 1.72). 01/2001; 18(2):120-123. DOI: 10.1023/A:1026543027300


It has been known that most cases of ovarian hyperstimulation syndrome (OHSS) are associated with the use of exogenous gonadotropins to induce multiple ovulation. However, OHSS is infrequently associated with a spontaneous ovulatory cycle, usually in the case of multiple gestations, hypothyroidism, or polycystic ovarian syndrome. We report a case of severe OHSS in a spontaneously pregnant woman with no underlying disease.

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    • "Elevated TSH in combination with normal serum FSH levels may get activated with FSH receptors, causing profound stimulation of ovarian follicles. Although it is not clear whether a similar action is operative in humans, the occurrence of spontaneous ovarian hyperstimulation syndrome in pregnant1528–30 and nonpregnant patients122930 with hypothyroidism supports this theory. "
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    ABSTRACT: Primary hypothyroidism may be associated with ovarian enlargement and/ or cyst formation. We evaluated the effect of thyroid hormone replacement therapy on hormonal changes, ovarian volume and sonographic appearance. Open, prospective study of women admitted to university gynecology clinic. The study included 26 patients with untreated hypothyroidism who had polycystic (n=10) or normal-appearing (n=16) ovaries and 20 euthyroidic controls. Basal serum total testosterone, free testosterone, androstenedione, dehydroepiandosterone-sulfate, prolactin, estradiol, luteinizing hormone, follicle-stimulating hormone, free T3, free T4 and thyroid-stimulating horone, together with ovarian volumes, were determined and repeated after euthyroidism was achieved. Ovarian volumes of patients with hypothyroidism were significantly greater compared with controls, and their magnitudes diminished significantly during thyroid hormone replacement therapy. Hypothyroidic patients with polycystic ovaries had significantly higher serum free testosterone and dehydroepiandosterone-sulfate, but lower androstenodione levels compared with those who had normal-appearing ovaries. Serum total testosterone concentrations were significantly higher in hypothyroidic patients without polycystic ovaries, and thyroid hormone replacement therapy achieved a significant reduction in total as well as free testosterone. Severe longstanding hypothyroidism leads to increased ovarian volume and/or cyst formation. A decrease in ovarian volume, resolution of ovarian cysts and reversal of the polycystic ovary syndrome-like appearance, together with improvement in serum hormone levels, occurred after euthyroidism was achieved.
    Annals of Saudi medicine 03/2011; 31(2):145-51. DOI:10.4103/0256-4947.77500 · 0.49 Impact Factor
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    • "In severe OHSS, massive ovarian enlargement, ascites, pleural effusion, haemoconcentration, oliguria, hypovolaemia, renal failure, thromboembolic episodes , adult respiratory distress syndrome, and death have been reported [1]. Spontaneous OHSS has been reported in women with hypothyroidism [2] [3] [4] [5] [6], polycystic ovary syndrome and pregnancy [7], gonadotroph pituitary adenoma [8], and normal pregnancy [9]. To our knowledge, only three cases of spontaneous OHSS have been described in non pregnant women with primary hypothyroidism [2] [3] [4]. "
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    ABSTRACT: A 22-year-old patient presented with abdominal pain and massive ovarian enlargement secondary to severe long standing hypothyroidism, mimicking an ovarian cancer. Treatment with L-thyroxin caused marked regression of the tumor.
    European Journal of Obstetrics & Gynecology and Reproductive Biology 02/2004; 112(1):107-9. DOI:10.1016/S0301-2115(03)00283-5 · 1.70 Impact Factor
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    • "77±96, 2003 DOI:10.1093/humupd/dmg005 Ó European Society of Human Reproduction and Embryology 1999; Pentz-Vidovic et al., 2000; Hee-Dong et al., 2001; Jung and Kim, 2001 "

    Human Reproduction Update 01/2003; 9(1):77-96. DOI:10.1093/humupd/dmg005 · 10.17 Impact Factor
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