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Ovarian Hyperstimulation Syndrome
Priyanka Jha, MBBS
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Ovarian hyperstimulation syndrome (OHSS)
              • Definitions

                • Clinical syndrome generally associated with ovulation induction
                  • Hyperstimulated, enlarged ovaries
                  • ↑ vascular permeability
                    • Ascites
                    • ± pleural effusion
                • Abdominal compartment syndrome-like condition

              IMAGING

              • Ultrasonographic Findings

                • MR Findings

                  • Imaging Recommendations

                    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. Petrenko AP et al: Assessing the usefulness of severity markers in women with ovarian hyperstimulation syndrome. Reprod Sci. 28(4):1041-8, 2021
                                    2. Ovarian Stimulation TEGGO et al: ESHRE guideline: ovarian stimulation for IVF/ICSI†. Hum Reprod Open. 2020(2):hoaa009, 2020
                                    3. Singh N et al: Severe early-onset ovarian hyperstimulation syndrome with liver dysfunction in an IVF segmentation cycle. BMJ Case Rep. 13(1), 2020
                                    4. Gómez GG et al: Immunoglobulin treatment in severe ovarian hyperstimulation syndrome. Eur J Case Rep Intern Med. 6(10):001253, 2019
                                    5. Hirshberg B et al: Multimodality imaging of acute locoregional and systemic complications in the setting of assisted reproduction. Emerg Radiol. 26(2):205-19, 2019
                                    6. Sharma N et al: The role of color Doppler in assisted reproduction: A narrative review. Int J Reprod Biomed. 17(11):779-88, 2019
                                    7. Al Salmi IS et al: Magnetic resonance imaging findings in ovarian torsion post in vitro fertilization. Radiol Case Rep. 13(6):1154-8, 2018
                                    8. Lainas GT et al: Ultrasound and hematological changes during early luteal phase in women at high risk for developing ovarian hyperstimulation syndrome. Ultrasound Obstet Gynecol. 51(1):126-33, 2018
                                    9. Rao A: Potential imaging findings following assisted reproduction: complications and clinical implications. Emerg Radiol. 25(1):73-86, 2018
                                    10. Asch E et al: Magnetic resonance imaging performance for diagnosis of ovarian torsion in pregnant women with stimulated ovaries. Fertil Res Pract. 3:13, 2017
                                    11. Nastri CO et al: Ovarian hyperstimulation syndrome: physiopathology, staging, prediction and prevention. Ultrasound Obstet Gynecol. 45(4):377-93, 2015
                                    12. Thornton KG et al: Ovarian hyperstimulation syndrome and arterial stroke. Stroke. 46(1):e6-8, 2015
                                    13. Mathur RS et al: British fertility society policy and practice committee: prevention of ovarian hyperstimulation syndrome. Hum Fertil (Camb). 17(4):257-68, 2014
                                    14. Baron KT et al: Emergent complications of assisted reproduction: expecting the unexpected. Radiographics. 33(1):229-44, 2013
                                    15. Tan BK et al: Management of ovarian hyperstimulation syndrome guidelines. Produced on behalf of the BFS Policy and Practice Committee. Hum Fertil (Camb). 16(3):160-1, 2013
                                    16. Kumar P et al: Ovarian hyperstimulation syndrome. J Hum Reprod Sci. 4(2):70-5, 2011
                                    17. Zivi E et al: Ovarian hyperstimulation syndrome: definition, incidence, and classification. Semin Reprod Med. 28(6):441-7, 2010
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Top Differential Diagnoses

                                          • Pathology

                                            • Clinical Issues

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Abbreviations

                                                  • Ovarian hyperstimulation syndrome (OHSS)
                                                • Definitions

                                                  • Clinical syndrome generally associated with ovulation induction
                                                    • Hyperstimulated, enlarged ovaries
                                                    • ↑ vascular permeability
                                                      • Ascites
                                                      • ± pleural effusion
                                                  • Abdominal compartment syndrome-like condition

                                                IMAGING

                                                • Ultrasonographic Findings

                                                  • MR Findings

                                                    • Imaging Recommendations

                                                      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. Petrenko AP et al: Assessing the usefulness of severity markers in women with ovarian hyperstimulation syndrome. Reprod Sci. 28(4):1041-8, 2021
                                                                      2. Ovarian Stimulation TEGGO et al: ESHRE guideline: ovarian stimulation for IVF/ICSI†. Hum Reprod Open. 2020(2):hoaa009, 2020
                                                                      3. Singh N et al: Severe early-onset ovarian hyperstimulation syndrome with liver dysfunction in an IVF segmentation cycle. BMJ Case Rep. 13(1), 2020
                                                                      4. Gómez GG et al: Immunoglobulin treatment in severe ovarian hyperstimulation syndrome. Eur J Case Rep Intern Med. 6(10):001253, 2019
                                                                      5. Hirshberg B et al: Multimodality imaging of acute locoregional and systemic complications in the setting of assisted reproduction. Emerg Radiol. 26(2):205-19, 2019
                                                                      6. Sharma N et al: The role of color Doppler in assisted reproduction: A narrative review. Int J Reprod Biomed. 17(11):779-88, 2019
                                                                      7. Al Salmi IS et al: Magnetic resonance imaging findings in ovarian torsion post in vitro fertilization. Radiol Case Rep. 13(6):1154-8, 2018
                                                                      8. Lainas GT et al: Ultrasound and hematological changes during early luteal phase in women at high risk for developing ovarian hyperstimulation syndrome. Ultrasound Obstet Gynecol. 51(1):126-33, 2018
                                                                      9. Rao A: Potential imaging findings following assisted reproduction: complications and clinical implications. Emerg Radiol. 25(1):73-86, 2018
                                                                      10. Asch E et al: Magnetic resonance imaging performance for diagnosis of ovarian torsion in pregnant women with stimulated ovaries. Fertil Res Pract. 3:13, 2017
                                                                      11. Nastri CO et al: Ovarian hyperstimulation syndrome: physiopathology, staging, prediction and prevention. Ultrasound Obstet Gynecol. 45(4):377-93, 2015
                                                                      12. Thornton KG et al: Ovarian hyperstimulation syndrome and arterial stroke. Stroke. 46(1):e6-8, 2015
                                                                      13. Mathur RS et al: British fertility society policy and practice committee: prevention of ovarian hyperstimulation syndrome. Hum Fertil (Camb). 17(4):257-68, 2014
                                                                      14. Baron KT et al: Emergent complications of assisted reproduction: expecting the unexpected. Radiographics. 33(1):229-44, 2013
                                                                      15. Tan BK et al: Management of ovarian hyperstimulation syndrome guidelines. Produced on behalf of the BFS Policy and Practice Committee. Hum Fertil (Camb). 16(3):160-1, 2013
                                                                      16. Kumar P et al: Ovarian hyperstimulation syndrome. J Hum Reprod Sci. 4(2):70-5, 2011
                                                                      17. Zivi E et al: Ovarian hyperstimulation syndrome: definition, incidence, and classification. Semin Reprod Med. 28(6):441-7, 2010