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CASE REPORT
Year : 2020  |  Volume : 3  |  Issue : 1  |  Page : 32-36

Rare occurrence of spontaneous ovarian hyperstimulation syndrome in frozen-thawed embryo transfer cycle resulting in healthy twin birth


GG Fertility Research and Women's Specialty Centre, Chennai, Tamil Nadu, India

Correspondence Address:
Dr. Kamala Selvaraj
GG Fertility Research and Women's Specialty Centre, Chennai, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/tofj.tofj_5_20

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This article is about an incidence of spontaneous ovarian hyperstimulation syndrome (OHSS) following a frozen embryo transfer (FET) with hormone replacement therapy. OHSS, a potentially life-threatening condition, is an iatrogenic complication of controlled ovarian stimulation; therefore, it is very important to prevent and treat OHSS with calculated doses of ovulation-inducing agents. The OHSS is triggered by vasoactive mediators, which are released from hyperstimulated ovaries. The syndrome can also occur in stimulation with clomiphene and gonadotropins. The occurrence of OHSS is more common in young women (<35 years) with low body mass index (BMI) (BMI<21 kg/m2), patients with polycystic ovarian syndrome, 10 and above antral follicle count, high serum estrogen concentration, and multiple ovarian follicles at the time of surrogate luteinizing hormone surge of human chorionic gonadotropin administration and multiple pregnancies. It is mandatory to freeze all the embryos and canceling that particular cycle to avoid OHSS. However, to our surprise we found OHSS occurring in frozen-thawed hormone replacement cycle. Although spontaneous OHSS (sOHSS) remains a rare event, females with a history of OHSS may have an elevated risk for sOHSS. Usual monitoring of pregnancy following FET helps in early diagnosis of this very rare condition which can be managed conservatively.


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