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First Case Report of Late-onset Ovarian Hyperstimulation Syndrome (ohss) With Right-sided Pleural Effusions Following a Spontaneous Pregnancy During a Luteal Phase Ovarian Stimulation Cycle

Year: 2025

Type: article

Abstract: Objective: To present a rare case of late-onset ovarian hyperstimulation syndrome (OHSS) with isolated right-sided pleural effusion occurring after spontaneous conception during a luteal phase ovarian stimulation cycle without exogenous human chorionic gonadotropin (hCG) administration. Design: Case report. Materials and Methods: A 36-year-old woman with primary infertility underwent luteal phase ovarian stimulation with menotropins, follitropin alfa, letrozole, and somatropin. By day 11 of stimulation, 17 follicles were noted and estradiol was 279 pg/mL. The cycle was canceled following a positive urine pregnancy test (serum β-hCG 53 mIU/mL). The patient discontinued stimulation medications and started progesterone injections. Subsequently, she presented multiple times to the emergency department due to recurrent dyspnea and right-sided pleural effusions requiring thoracenteses. Results: Initial thoracentesis drained 1,500 cc of straw-colored fluid. The patient had recurrent effusions requiring additional drainage procedures of 1,800 cc and 1,400 cc. Laboratory findings included mild hyponatremia, hypocalcemia, and hypoalbuminemia. After final hospitalization, a pigtail catheter drained 1,600 cc. The patient stabilized with conservative management. Ultrasound confirmed a viable singleton pregnancy carried to 32 weeks and 4 days, resulting in a successful delivery. Conclusions: This case highlights late-onset OHSS triggered by endogenous hCG following spontaneous conception during luteal phase ovarian stimulation. Clinicians should be vigilant of OHSS risks even in the absence of exogenous hCG administration. Routine pregnancy checks and close monitoring during luteal phase stimulation cycles are critical to early detection and effective management of severe OHSS complications, such as pleural effusions.

Source: North American Proceedings in Gynecology and Obstetrics - Supplemental

DOI: 10.54053/001c.142090

Authors: Alice Emole, Navyaa Sinha, Dana Aboukhalil, Aimee Eyvazzadeh

Institution: California Northstate University

Language: English

Topic: Ovarian function and disorders

Subfield: Reproductive Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

OpenAlex ID: W4413073441

FWCI:

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