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Hyperstimulation Syndrome
Karen Y. Oh, MD; Shawn E. Gurtcheff, MD, MS
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Ovarian hyperstimulation syndrome (OHSS)
            • Definitions

              • Clinical syndrome associated with an exaggerated response to ovulation induction
                • Hyperstimulated, enlarged ovaries with ovarian cysts due to multifollicular development
                • Increased vascular permeability
                  • Ascites
                  • ± pleural effusion
                  • Hemoconcentration

            IMAGING

            • Ultrasonographic Findings

              • MR Findings

                • Imaging Recommendations

                  • Radiographic Findings

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Gross Pathologic & Surgical Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Image Interpretation Pearls

                                    Selected References

                                    1. Venetis CA et al: Intravenous albumin administration for the prevention of severe ovarian hyperstimulation syndrome: a systematic review and metaanalysis. Fertil Steril. 95(1):188-96, 196, 2011
                                    2. Chang EM et al: Ultrasound-guided transvaginal aspiration as initial treatment for adnexal torsion following ovarian hyperstimulation. Eur J Obstet Gynecol Reprod Biol. 152(1):60-3, 2010
                                    3. George K et al: Symptomatic unilateral pleural effusion: A rare presentation of ovarian hyperstimulation syndrome. J Hum Reprod Sci. 3(1):49-51, 2010
                                    4. Gibbons WE et al: Practice Committee documents: an effort to improve practice. Fertil Steril. 92(5):1515-6, 2009
                                    5. Saul T et al: Ovarian hyperstimulation syndrome. Am J Emerg Med. 27(2):250, 2009
                                    6. Gunabushanam G et al: Hemoperitoneum from ruptured cyst in a hyperstimulated ovary: a sonographic mimic of ovarian hyperstimulation syndrome. J Clin Ultrasound. 35(5):281-3, 2007
                                    7. Suzuki S: Comparison between spontaneous ovarian hyperstimulation syndrome and hyperreactio luteinalis. Arch Gynecol Obstet. 269(3):227-9, 2004
                                    8. Aboulghar MA et al: Ovarian hyperstimulation syndrome: classifications and critical analysis of preventive measures. Hum Reprod Update. 9(3):275-89, 2003
                                    9. Delvigne A et al: Review of clinical course and treatment of ovarian hyperstimulation syndrome (OHSS). Hum Reprod Update. 9(1):77-96, 2003
                                    10. Practice Committe of the American Society for Reproductive Medicine: Ovarian hyperstimulation syndrome. Fertil Steril. 80(5):1309-14, 2003
                                    11. Delvigne A et al: Epidemiology and prevention of ovarian hyperstimulation syndrome (OHSS): a review. Hum Reprod Update. 8(6):559-77, 2002
                                    12. McNeary M et al: Radiographic findings in ovarian hyperstimulation syndrome. J Thorac Imaging. 17(3):230-2, 2002
                                    13. Jung BG et al: Severe spontaneous ovarian hyperstimulation syndrome with MR findings. J Comput Assist Tomogr. 25(2):215-7, 2001
                                    14. Mathur RS et al: Distinction between early and late ovarian hyperstimulation syndrome. Fertil Steril. 73(5):901-7, 2000
                                    15. Morris RS et al: Conservative management of ovarian hyperstimulation syndrome. J Reprod Med. 40(10):711-4, 1995
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Top Differential Diagnoses

                                          • Clinical Issues

                                            • Diagnostic Checklist

                                              TERMINOLOGY

                                              • Abbreviations

                                                • Ovarian hyperstimulation syndrome (OHSS)
                                              • Definitions

                                                • Clinical syndrome associated with an exaggerated response to ovulation induction
                                                  • Hyperstimulated, enlarged ovaries with ovarian cysts due to multifollicular development
                                                  • Increased vascular permeability
                                                    • Ascites
                                                    • ± pleural effusion
                                                    • Hemoconcentration

                                              IMAGING

                                              • Ultrasonographic Findings

                                                • MR Findings

                                                  • Imaging Recommendations

                                                    • Radiographic Findings

                                                      DIFFERENTIAL DIAGNOSIS

                                                        PATHOLOGY

                                                        • General Features

                                                          • Gross Pathologic & Surgical Features

                                                            CLINICAL ISSUES

                                                            • Presentation

                                                              • Demographics

                                                                • Natural History & Prognosis

                                                                  • Treatment

                                                                    DIAGNOSTIC CHECKLIST

                                                                    • Image Interpretation Pearls

                                                                      Selected References

                                                                      1. Venetis CA et al: Intravenous albumin administration for the prevention of severe ovarian hyperstimulation syndrome: a systematic review and metaanalysis. Fertil Steril. 95(1):188-96, 196, 2011
                                                                      2. Chang EM et al: Ultrasound-guided transvaginal aspiration as initial treatment for adnexal torsion following ovarian hyperstimulation. Eur J Obstet Gynecol Reprod Biol. 152(1):60-3, 2010
                                                                      3. George K et al: Symptomatic unilateral pleural effusion: A rare presentation of ovarian hyperstimulation syndrome. J Hum Reprod Sci. 3(1):49-51, 2010
                                                                      4. Gibbons WE et al: Practice Committee documents: an effort to improve practice. Fertil Steril. 92(5):1515-6, 2009
                                                                      5. Saul T et al: Ovarian hyperstimulation syndrome. Am J Emerg Med. 27(2):250, 2009
                                                                      6. Gunabushanam G et al: Hemoperitoneum from ruptured cyst in a hyperstimulated ovary: a sonographic mimic of ovarian hyperstimulation syndrome. J Clin Ultrasound. 35(5):281-3, 2007
                                                                      7. Suzuki S: Comparison between spontaneous ovarian hyperstimulation syndrome and hyperreactio luteinalis. Arch Gynecol Obstet. 269(3):227-9, 2004
                                                                      8. Aboulghar MA et al: Ovarian hyperstimulation syndrome: classifications and critical analysis of preventive measures. Hum Reprod Update. 9(3):275-89, 2003
                                                                      9. Delvigne A et al: Review of clinical course and treatment of ovarian hyperstimulation syndrome (OHSS). Hum Reprod Update. 9(1):77-96, 2003
                                                                      10. Practice Committe of the American Society for Reproductive Medicine: Ovarian hyperstimulation syndrome. Fertil Steril. 80(5):1309-14, 2003
                                                                      11. Delvigne A et al: Epidemiology and prevention of ovarian hyperstimulation syndrome (OHSS): a review. Hum Reprod Update. 8(6):559-77, 2002
                                                                      12. McNeary M et al: Radiographic findings in ovarian hyperstimulation syndrome. J Thorac Imaging. 17(3):230-2, 2002
                                                                      13. Jung BG et al: Severe spontaneous ovarian hyperstimulation syndrome with MR findings. J Comput Assist Tomogr. 25(2):215-7, 2001
                                                                      14. Mathur RS et al: Distinction between early and late ovarian hyperstimulation syndrome. Fertil Steril. 73(5):901-7, 2000
                                                                      15. Morris RS et al: Conservative management of ovarian hyperstimulation syndrome. J Reprod Med. 40(10):711-4, 1995