Ovarian hyperstimulation syndrome (OHSS) in spontaneous pregnancy

It has been known that most cases of ovarian hyperstimulation syndrome (OHSS) are almost exclusively associated with controlled ovarian stimulation with gonadotrophins or occasionally, clomiphene citrate. However, OHSS is also infrequently associated with a ontaneous ovulatory cycle, usually in the case of multiple gestations, hypothyroidism, or severe forms of polycystic ovarian syndrome. Severe OHSS associated with a spontaneously conceived prhyperstimulation syndrome (sOHSS) in a woman who conceived spontaneously with no underlying disease. All associated risk factors were excluded, such as multiple gestations, hypothyroidism, or polycystic ovarian syndrome. Purpose of this case report is to discuss about the condition which can be associated morbidity and even mortality, if remain undiagnosed and if not managed properly. Furthermore, it is interesting to note that exploratory laparotomy was performed in six cases, because an ovarian cancer was suspected. Therefore, clinicians must bear the differential diagnosis of OHSS in mind if a patient presents with gross ascites and other symptoms of ovarian cancer, which also may be signs of OHSS. This case report emphasis that by taking all possible differential diagnoses into account, unnecessary laparotomy may be avoided pregnancy is are with only few previous reports.