Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2019; 7(24): 4384-4390
Published online Dec 26, 2019. doi: 10.12998/wjcc.v7.i24.4384
Spontaneous ovarian hyperstimulation syndrome: Report of two cases
Juan Gui, Jie Zhang, Wang-Ming Xu, Lei Ming
Juan Gui, Jie Zhang, Wang-Ming Xu, Lei Ming, Reproductive Center, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province China
Juan Gui, Wang-Ming Xu, Lei Ming, Assisted Reproduction and Embryogenesis Clinical Research Center of Hubei Province, Wuhan 430060, Hubei Province, China
Author contributions: Gui J and Zhang J were the patient’s attending doctors, contributed to manuscript drafting, and analyzed and interpreted the imaging findings; Xu WM and Ming L were responsible for the revision of the manuscript. All authors issued final approval for the version to be submitted.
Supported by the National Natural Science Foundation of China, No. 81601248.
Informed consent statement: Written informed consent was obtained from the patients for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Lei Ming, MD, Professor, Reproductive Center, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang District, Wuhan 430060, Hubei Province, China. rmobg2015@163.com
Telephone: +86-27-88041911-81570 Fax: +86-27-88041911-81571
Received: September 5, 2019
Peer-review started: September 5, 2019
First decision: September 23, 2019
Revised: November 1, 2019
Accepted: November 23, 2019
Article in press: November 23, 2019
Published online: December 26, 2019
Processing time: 111 Days and 6.7 Hours
Abstract
BACKGROUND

Spontaneous ovarian hyperstimulation syndrome (sOHSS) is extremely rare. It can be divided into four types according to its clinical manifestations and follicle stimulating hormone receptor mutations.

CASE SUMMARY

Here we report two cases of sOHSS in Chinese women, one with a singleton gestation developing sOHSS in the first trimester who conceived naturally and the other with a twin pregnancy developing sOHSS in the second trimester after a thawed embryo transfer cycle. Both patients were admitted to the hospital with abdominal distension, ascites, and enlarged ovaries. Conservative treatment was the primary option of management. The first patient had spontaneous onset labor at 40 wk of gestation and underwent an uncomplicated vaginal delivery of a male newborn. The second patient delivered a female baby and a male baby by caesarean section at 35 wk and 1 d of gestation.

CONCLUSION

Patients with a history of ovarian hyperstimulation syndrome should be closely monitored. Single embryo transfer might reduce the risk of this rare syndrome.

Keywords: Ovarian hyperstimulation syndrome; Natural pregnancy; Thawed embryo transfer cycle; Case report

Core tip: Spontaneous ovarian hyperstimulation syndrome (sOHSS) is extremely rare. It is always confused with ovarian tumors due to their similar symptoms. Here we report two cases of sOHSS, one woman with a singleton gestation developing sOHSS in the first trimester who conceived naturally and the other with a twin pregnancy in the second trimester after a thawed embryo transfer cycle. The first line investigation for the diagnosis is pelvic ultrasonography. Since sOHSS cannot be predicted, patients with a history of OHSS should be closely monitored. The primary management option is conservative therapy. Single embryo transfer may decrease the risk of developing severe OHSS in assisted reproductive cases.