Thoracic manifestations of ovarian hyperstimulation syndrome.
OBJECTIVE
To determine the thoracic manifestations of severe ovarian hyperstimulation syndrome, the major serious complication of induction of superovulation with exogenous gonadotropins.


METHODS
The authors reviewed the medical records and available images for 771 patients who had received gonadotropins to induce superovulation for in-vitro fertilization and embryo transfer or intrauterine insemination of concentrated sperm. The patients, ranging in age from 28 to 43 years, had been treated between October 1990 and July 1992.


RESULTS
In 22 patients (3%) severe hyperstimulation syndrome was diagnosed clinically and confirmed with ultrasonography. Pleural effusion occurred in five of these (23%), one of whom required thoracentesis. Atelectasis, associated with adult respiratory distress syndrome (ARDS) and internal jugular vein thrombosis, developed in one patient, and ventilation-perfusion mismatch of uncertain cause occurred in another.


CONCLUSIONS
Respiratory distress in patients with ovarian hyperstimulation syndrome is most likely due to lung restriction caused by ascites, the large cystic ovaries, or pleural or pericardial effusion. Pulmonary embolism and ARDS may rarely occur. Pulmonary manifestations, not previously well recognized, form an important part of this syndrome, and radiologic input with regard to assessment, monitoring and management are needed.
Department of Diagnostic Radiology and Nuclear Medicine, University Hospital, London, Ont.
M F
MF
Levin
B R
BR
Kaplan
L C
LC
Hutton
D000328:Adult; D005260:Female; D006801:Humans; D016471:Ovarian Hyperstimulation Syndrome / Q000000981:diagnostic imaging*; D010996:Pleural Effusion / Q000000981:diagnostic imaging; D011859:Radiography; D012189:Retrospective Studies; D013896:Thoracic Diseases / Q000000981:diagnostic imaging*; D014463:Ultrasonography