Spontaneous ovarian hyperstimulation syndrome following a thawed embryo transfer cycle

Mi Kyoung Kim, Hyung Jae Won, Sung Han Shim, Dong Hyun Cha, Tae Ki Yoon, Mi Kyoung Kim, Hyung Jae Won, Sung Han Shim, Dong Hyun Cha, Tae Ki Yoon

Abstract

This article reports a case of spontaneous ovarian hyperstimulation syndrome (OHSS) following a thawed embryo transfer cycle. OHSS, a potentially life-threatening condition, is an iatrogenic complication of controlled ovarian stimulation; therefore, it is very important to prevent and treat OHSS during treatment with ovulation-inducing agents. Despite our efforts to prevent OHSS, in this case, severe spontaneous OHSS occurred, which resulted in uncontrolled preterm labor and a preterm delivery and also persisted for 6 weeks after delivery. Freezing all embryos cannot entirely prevent the development of OHSS because OHSS can occur spontaneously. Although spontaneous OHSS remains a rare event, females with a history of OHSS may have an elevated risk for spontaneous OHSS. We suggest closely monitoring cases of pregnancy following thawed embryo transfer for early diagnosis of spontaneous OHSS and the use of conservative management.

Keywords: Cryopreservation; In vitro fertilization; Ovarian hyperstimulation syndrome.

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1
(A) Transvaginal ultrasonography indicated an enlarged left ovary with multiple follicular cysts at 11 weeks gestation, (B) gradually progressing enlargement of the left ovary at 13 weeks gestation, (C) slightly decreased size of the hyperstimulated ovaries at 6 weeks postpartum, and (D) resolution of the ovarian enlargement at 5 months after delivery. RO, right ovary; LO, left ovary.
Figure 2
Figure 2
FSH receptor variations: (A) intron 4c374+69 T>C, (B) exon 10 Ala307Thr, and (C) exon 10 Ser680Asn.
Figure 3
Figure 3
(A, B) Photographs of hyperstimulated ovaries (white arrows) during the Caesarean section.

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