Introduction
Ovarian Hyperstimulation Syndrome (OHSS) is a known complication of in-vitro fertilization (IVF), but when it presents as an isolated pleural effusion, diagnosis becomes complex. A recent case report sheds light on this rare and often overlooked manifestation.
Visit https://www.obstetricgynecoljournal.com for more groundbreaking research in this field.
Unusual Case Breathing Trouble Unmasks OHSS
A 44-year-old woman presented with chest discomfort, cough, and breathing difficulty just 10 days after embryo transfer. Notably, this was her fourth IVF cycle each previously complicated by OHSS. However, this time, the absence of abdominal ascites initially puzzled clinicians.
Key findings:
- Ultrasound and X-ray revealed a right-sided pleural effusion.
- Laboratory results: Normal CBC and kidney function; decreased serum albumin.
- Pleural fluid analysis: High protein (exudate), with reactive cells but no infection.
A chest drain removed 2150 ml of fluid over 3 days, resolving symptoms. She later delivered a healthy baby via cesarean section.
Medical Perspective: Why This Matters
OHSS typically involves ovarian enlargement and fluid buildup in the abdomen. However, unilateral pleural effusion without ascites is extremely rare—reported in less than 1% of OHSS cases.
- How does this happen?
- Leakage of fluid from the abdomen to the chest via microscopic defects in the diaphragm or lymphatic channels.
- Right-side effusions are more common due to anatomical reasons.
Risk Factors & Prevention
Understanding who is at risk is essential. Common OHSS risk factors include:
- Polycystic ovarian syndrome (PCOS)
- High antral follicle count and AMH levels
- Prior history of OHSS
Preventive strategies:
- Use of GnRH agonists over HCG
- Freeze-all embryo policies
- Minimal stimulation IVF protocols
Recent studies advocate for in vitro maturation and personalized stimulation regimens to mitigate OHSS without significantly reducing success rates.
Read the full study at: https://doi.org/10.29328/journal.cjog.1001074
Clinical Implications & Future Outlook
This case reinforces the need for vigilance. Even in the absence of typical symptoms like abdominal bloating, clinicians must consider OHSS in post IVF patients with unexplained respiratory issues.
- Encourage early imaging when respiratory symptoms occur post embryo transfer.
- Develop and adopt institutional protocols for OHSS risk assessment.
- Educate patients about the risks and options for safer IVF practices.
Explore similar studies in our case reports section.
Call-to-Action
Explore more studies at https://www.obstetricgynecoljournal.com and join the conversation by sharing your thoughts in the comments below!
Heighten Science Publications Inc. 
Leave a comment