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Ovarian Hyperstimulation Syndrome
Marc S. Tubay, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Abbreviations

            • Ovarian hyperstimulation syndrome (OHSS)
          • Definitions

            • Rare complication of ovarian induction for assisted reproductive techniques
              • Usually iatrogenic
              • Spontaneous OHSS is extremely rare

          IMAGING

          • General Features

            • CT Findings

              • MR Findings

                • Ultrasonographic Findings

                  • Imaging Recommendations

                    • Radiographic Findings

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Ackerman S et al: Ovarian cystic lesions: a current approach to diagnosis and management. Radiol Clin North Am. 51(6):1067-85, 2013
                                            2. Baron KT et al: Emergent complications of assisted reproduction: expecting the unexpected. Radiographics. 33(1):229-44, 2013
                                            3. Lalwani N et al: Miscellaneous tumour-like lesions of the ovary: cross-sectional imaging review. Br J Radiol. 85(1013):477-86, 2012
                                            4. Cicchiello LA et al: Ultrasound evaluation of gynecologic causes of pelvic pain. Obstet Gynecol Clin North Am. 38(1):85-114, viii, 2011
                                            5. Kumar P et al: Ovarian hyperstimulation syndrome. J Hum Reprod Sci. 4(2):70-5, 2011
                                            6. Shanbhogue AK et al: Spectrum of medication-induced complications in the abdomen: role of cross-sectional imaging. AJR Am J Roentgenol. 197(2):W286-94, 2011
                                            7. Nastri CO et al: Ovarian hyperstimulation syndrome: pathophysiology and prevention. J Assist Reprod Genet. 27(2-3):121-8, 2010
                                            8. Chiou SY et al: Adnexal torsion: new clinical and imaging observations by sonography, computed tomography, and magnetic resonance imaging. J Ultrasound Med. 26(10):1289-301, 2007
                                            9. Pedrosa I et al: MR imaging of acute right lower quadrant pain in pregnant and nonpregnant patients. Radiographics. 27(3):721-43; discussion 743-53, 2007
                                            10. Cepni I et al: Spontaneous ovarian hyperstimulation syndrome presenting with acute abdomen. J Postgrad Med. 52(2):154-5, 2006
                                            11. Eyvazzadeh AD et al: Imaging of pelvic pain in the first trimester of pregnancy. Radiol Clin North Am. 44(6):863-77, 2006
                                            12. Tamai K et al: MR features of physiologic and benign conditions of the ovary. Eur Radiol. 2006
                                            13. Imaoka I et al: MR imaging of disorders associated with female infertility: use in diagnosis, treatment, and management. Radiographics. 23(6):1401-21, 2003
                                            14. Bennett GL et al: Gynecologic causes of acute pelvic pain: spectrum of CT findings. Radiographics. 22(4):785-801, 2002
                                            15. Delvigne A et al: Epidemiology and prevention of ovarian hyperstimulation syndrome (OHSS): a review. Hum Reprod Update. 8(6):559-77, 2002
                                            16. McNeary M et al: Radiographic findings in ovarian hyperstimulation syndrome. J Thorac Imaging. 17(3):230-2, 2002
                                            17. Jung BG et al: Severe spontaneous ovarian hyperstimulation syndrome with MR findings. J Comput Assist Tomogr. 25(2):215-7, 2001
                                            18. Pinkas H et al: Doppler parameters of uterine and ovarian stromal blood flow in women with polycystic ovary syndrome and normally ovulating women undergoing controlled ovarian stimulation. Ultrasound Obstet Gynecol. 12(3):197-200, 1998
                                            19. Kim IY et al: Ovarian hyperstimulation syndrome. US and CT appearances. Clin Imaging. 21(4):284-6, 1997
                                            20. Levine CD et al: Benign extraovarian mimics of ovarian cancer. Distinction with imaging studies. Clin Imaging. 21(5):350-8, 1997
                                            21. Man A et al: Pleural effusion as a presenting symptom of ovarian hyperstimulation syndrome. Eur Respir J. 10(10):2425-6, 1997
                                            22. Levin MF et al: Thoracic manifestations of ovarian hyperstimulation syndrome. Can Assoc Radiol J. 46(1):23-6, 1995
                                            23. Outwater EK et al: Imaging of the ovary and adnexa: clinical issues and applications of MR imaging. Radiology. 194(1):1-18, 1995
                                            24. Takahashi K et al: Transvaginal ultrasonographic morphology in polycystic ovarian syndrome. Gynecol Obstet Invest. 39(3):201-6, 1995
                                            25. Rankin RN et al: Ultrasound in the ovarian hyperstimulation syndrome. J Clin Ultrasound. 9(9):473-6, 1981
                                            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

                                                    TERMINOLOGY

                                                    • Abbreviations

                                                      • Ovarian hyperstimulation syndrome (OHSS)
                                                    • Definitions

                                                      • Rare complication of ovarian induction for assisted reproductive techniques
                                                        • Usually iatrogenic
                                                        • Spontaneous OHSS is extremely rare

                                                    IMAGING

                                                    • General Features

                                                      • CT Findings

                                                        • MR Findings

                                                          • Ultrasonographic Findings

                                                            • Imaging Recommendations

                                                              • Radiographic Findings

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Staging, Grading, & Classification

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Ackerman S et al: Ovarian cystic lesions: a current approach to diagnosis and management. Radiol Clin North Am. 51(6):1067-85, 2013
                                                                                      2. Baron KT et al: Emergent complications of assisted reproduction: expecting the unexpected. Radiographics. 33(1):229-44, 2013
                                                                                      3. Lalwani N et al: Miscellaneous tumour-like lesions of the ovary: cross-sectional imaging review. Br J Radiol. 85(1013):477-86, 2012
                                                                                      4. Cicchiello LA et al: Ultrasound evaluation of gynecologic causes of pelvic pain. Obstet Gynecol Clin North Am. 38(1):85-114, viii, 2011
                                                                                      5. Kumar P et al: Ovarian hyperstimulation syndrome. J Hum Reprod Sci. 4(2):70-5, 2011
                                                                                      6. Shanbhogue AK et al: Spectrum of medication-induced complications in the abdomen: role of cross-sectional imaging. AJR Am J Roentgenol. 197(2):W286-94, 2011
                                                                                      7. Nastri CO et al: Ovarian hyperstimulation syndrome: pathophysiology and prevention. J Assist Reprod Genet. 27(2-3):121-8, 2010
                                                                                      8. Chiou SY et al: Adnexal torsion: new clinical and imaging observations by sonography, computed tomography, and magnetic resonance imaging. J Ultrasound Med. 26(10):1289-301, 2007
                                                                                      9. Pedrosa I et al: MR imaging of acute right lower quadrant pain in pregnant and nonpregnant patients. Radiographics. 27(3):721-43; discussion 743-53, 2007
                                                                                      10. Cepni I et al: Spontaneous ovarian hyperstimulation syndrome presenting with acute abdomen. J Postgrad Med. 52(2):154-5, 2006
                                                                                      11. Eyvazzadeh AD et al: Imaging of pelvic pain in the first trimester of pregnancy. Radiol Clin North Am. 44(6):863-77, 2006
                                                                                      12. Tamai K et al: MR features of physiologic and benign conditions of the ovary. Eur Radiol. 2006
                                                                                      13. Imaoka I et al: MR imaging of disorders associated with female infertility: use in diagnosis, treatment, and management. Radiographics. 23(6):1401-21, 2003
                                                                                      14. Bennett GL et al: Gynecologic causes of acute pelvic pain: spectrum of CT findings. Radiographics. 22(4):785-801, 2002
                                                                                      15. Delvigne A et al: Epidemiology and prevention of ovarian hyperstimulation syndrome (OHSS): a review. Hum Reprod Update. 8(6):559-77, 2002
                                                                                      16. McNeary M et al: Radiographic findings in ovarian hyperstimulation syndrome. J Thorac Imaging. 17(3):230-2, 2002
                                                                                      17. Jung BG et al: Severe spontaneous ovarian hyperstimulation syndrome with MR findings. J Comput Assist Tomogr. 25(2):215-7, 2001
                                                                                      18. Pinkas H et al: Doppler parameters of uterine and ovarian stromal blood flow in women with polycystic ovary syndrome and normally ovulating women undergoing controlled ovarian stimulation. Ultrasound Obstet Gynecol. 12(3):197-200, 1998
                                                                                      19. Kim IY et al: Ovarian hyperstimulation syndrome. US and CT appearances. Clin Imaging. 21(4):284-6, 1997
                                                                                      20. Levine CD et al: Benign extraovarian mimics of ovarian cancer. Distinction with imaging studies. Clin Imaging. 21(5):350-8, 1997
                                                                                      21. Man A et al: Pleural effusion as a presenting symptom of ovarian hyperstimulation syndrome. Eur Respir J. 10(10):2425-6, 1997
                                                                                      22. Levin MF et al: Thoracic manifestations of ovarian hyperstimulation syndrome. Can Assoc Radiol J. 46(1):23-6, 1995
                                                                                      23. Outwater EK et al: Imaging of the ovary and adnexa: clinical issues and applications of MR imaging. Radiology. 194(1):1-18, 1995
                                                                                      24. Takahashi K et al: Transvaginal ultrasonographic morphology in polycystic ovarian syndrome. Gynecol Obstet Invest. 39(3):201-6, 1995
                                                                                      25. Rankin RN et al: Ultrasound in the ovarian hyperstimulation syndrome. J Clin Ultrasound. 9(9):473-6, 1981