Presentation
Egg retrieval yesterday for in vitro fertilization. Now presenting with shortness of breath, chest and abdominal pain, tachycardia, positive d-dimer, and leukocytosis. Evaluate for PE or intraabdominal pathology.
Patient Data
The ovaries are markedly enlarged. The right ovary is located in the pelvis posterior to the uterus, while the left ovary is located in the left mid abdomen and the midline superior to the uterus. The enlarged ovaries contain numerous cysts, some of which measure fluid density, while multiple other follicles contain high density hemorrhage. The right ovary contains numerous follicles with hemorrhage along the dependent and right lateral aspects. Findings of hemorrhage within the follicles are likely related to the given history of egg retrieval. There are prominent serpiginous venous vessels in the adnexal regions, left greater than right, but there is no evidence of active extravasation. There is a moderate amount of high density proteinaceous fluid throughout the abdomen and pelvis, extending to surround the liver and the spleen. There is fluid tracking along the spleen which has several prominent splenic clefts.
Case Discussion
This is a case of ovarian hyperstimulation syndrome. Following the patient's egg retrieval procedure for in vitro fertilization, the ovaries became grossly enlarged with numerous cysts. The patient was treated with conservative measures and eventually fully recovered.
Co-author:
Christine Cooley, MD
Unable to process the form. Check for errors and try again.