Problems encountered while managing a case of severe ovarian hyperstimulation syndrome

ABSTRACT

This is the case of a 26 year-old nulligravida with Polycystic Ovary Syndrome who developed severe Ovarian Hyperstimulation Syndrome (OHSS) during ovulation induction for Intrauterine Insemination (IUI). Three problems were encountered during treatment. The first was whether to convert a planned ovulation induction and IUI, that resulted in multiple follicular development, to an in vitro Fertilization - Intracytoplasmic Sperm Injection cycle. The second problem was determining what strategies are relevant in preventing OHSS in a woman at high risk for developing severe hyperstimulation. The third problem was why, when and how to employ abdominal paracentesis in the management of severe OHSS. Though the patient's course was turbulent, management was successful. She is now awaiting embryo transfer and, ultimately, motherhood.