Year: 2026
Type: article
Study design: Case Report
Abstract: Ovarian Hyperstimulation Syndrome (OHSS) is characterized by increased vascular permeability, hemoconcentration, and fluid leakage into the third space. The vast majority of OHSS cases occur following ovarian stimulation for IVF. This potentially lethal iatrogenic condition is one of the most serious complications of assisted reproductive technologies. We report a case of early OHSS after GnRH agonist trigger in a GnRH antagonist protocol and a "freeze-all" approach, without the administration of any hCG for luteal-phase support, in a 28-year-old patient with PCO and a history of recurrent pregnancy loss. The patient had a history of two miscarriages at 7 weeks gestation without Fetal Heart Rate (FHR); prior to these events, she had no clinical problems. After oocyte retrieval, the patient presented to the emergency unit with weakness, vertigo, and dyspnea. Vital signs were oxygen saturation 89%, pulse rate 110 bpm, and respiratory rate 25 breaths/min. She managed supplemental oxygen via mask, intravenous fluids, anticoagulants, and strict intake-output charting. D-dimer levels were checked and were within the normal range. CT angiography was performed, revealing bilateral pleural effusion. This case presents clinical manifestations, investigation, progress, management, outcome, and preventive measures. The patient was managed successfully with no further complications. Clinicians should be aware that even the sequential approach of ovarian stimulation with a "freeze-all" strategy and GnRH agonist triggering cannot eliminate the risk of OHSS in all patients.
Language: English
Subfield: Reproductive Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7166867255