Ovarian hyperstimulation syndrome with a twist: a rare case of adnexal torsion complicating severe ovarian hyperstimulation syndrome

Ovarian hyperstimulation syndrome (OHSS) is a serious complication of ovarian stimulation protocol. This rare case highlights a patient with severe OHSS complicated by adnexaltorsion. A 24-year-old married woman with history of oocyte donation presented in tertiary care centre with complaints of progressive abdominal pain, distension and shortness of breath. Clinical examination and investigations confirmed diagnosis of severe OHSS and right sided enlarged ovary (1190 cc) with torsion. Emergency laparotomy with right salpingo-oophorectomy was done. Adnexal torsion is common due to ovarian enlargement is common amongst patients undergoing ovulation induction. Doppler ultrasound aids the diagnosis, and surgical intervention is warranted. Early recognition of patient at risk of OHSS is essential for its prevention. Surgical management of adnexal torsion in OHSS is crucial to avoid complications.