Ovarian hyperstimulation syndrome

  • Potential life-threatening complication
  • Occurs during luteal phase or early pregnancy following IVF ovarian stimulation
  • Caused by vasoactive substances that increase vascular permeability, ascitic fluid shift into abdomen
  • Abdominal distension, nausea, vomiting, weight gain
  • Pleural effusion, intravascular fluid depletion, hemoconcentration, thromboses, renal failure, shock
Imaging
  • USG – technique of choice
    • Bilateral symmetrical enlarged ovaries (≥6 cm)
    • Multiple peripheral-placed thin walled cysts/follicles
    • Enlarged ovaries can prolapse out of pelvis into iliac fossa
    • Normal uterine position
    • Echogenic stroma from edema and hemorrhage
    • Free peritoneal fluid/ascites or pleural effusion
    • Normal or increased vascularity on Doppler
Read more

Mittal, Kartik, et al. “Radiological illustration of spontaneous ovarian hyperstimulation syndrome.” Polish journal of radiology 80 (2015): 217.

GARDNER, GEORGEMARY. “Ovarian Hyperstimulation Syndrome (OHSS): How Much Do We Really Know About It?.” Radiology 196.2 (1995): 452-452.