Is this appearance compatible with ovarian hyperstimulation syndrome?
Although enlarged ovaries and free pelvic fluid / ascites are seen in OHSS, many prominent ovarian follicles should be present. In this case, only a few small follicles are present at the periphery, with a homogenously echoic central ovary. The clinical history is also not compatible, since B-hCG level would likely be elevated from the induction therapy. It should be kept in mind however, that OHSS is a risk factor for torsion.
Collection of key images for the case:
- spectral Doppler detects a small amount of blood flow in the right ovary
- MR sequences to evaluate mass demonstrate a markedly asymmetrically enlarged right ovary, which has a twisted right adnexa (right open arrow), which demonstrates marked edema, and which has only a few small peripheral follicles