Chahal R and Pakrashi T
Background: Ovarian hyperstimulation syndrome remains a significant cause of morbidity in ovulation induction. It may be further complicated by thromboembolism and pleural effusions.
Case Report: A 30-year-old nulligravida underwent ovarian stimulation with OCP/Antagonist protocol for in vitro fertilization. Estradiol levels peaked at 2411 pg/mL. Post-stimulation course was complicated by recurrent pleural effusions and an occlusive right internal jugular vein thrombosis. The patient underwent repeated thoracenteses with a drainage of a total of 8350 cc of pleural fluid. The patient received therapeutic anticoagulation and delivered a viable infant at term. Imaging at six weeks postpartum revealed a chronic, non-occlusive deep venous thrombosis involving both the right internal jugular and right subclavian veins.
Conclusion: OHSS results in dynamic changes that contribute to thrombosis and massive fluid shifts. Further research is needed to optimize prevention strategies.
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