Moderate Ovarian Hyperstimulation Syndrome in a Nulliparous Oocyte Donor: A Case Report

Background: Ovarian hyperstimulation syndrome (OHSS) is a potentially fatal iatrogenic side effect of regulated ovarian hyperstimulation used for assisted reproduction. The pathogenesis of OHSS is unknown, however, the process is related to increased vascular permeability which leads to fluid shift into the extravascular space leading to ascites, hemoconcentration and electrolyte imbalances. Currently, vaso-active mediators mainly vascular endothelial growth factor produced by the granulosa cells are essential to the pathogenesis of OHSS. Case Presentation: She is a 22-year-old lady who presented to St. Elizabeth Hospital and Fertility Centre, Enugu, Nigeria with a history of abdominal swelling of one day duration. She had undergone oocyte retrieval 6 days prior to presentation. Abdominal examination and ultrasonographic findings were in keeping with moderate (Grade 3) OHSS. She was given tablet cabergoline 0.5 mg daily for 3 days and she also had two transvaginal ultrasound guided ascitic fluid aspirations and she recovered thereafter. Conclusion: OHSS is a serious complication of controlled ovarian stimulation and should be anticipated in assisted reproductive technology treatments.