title: Late ovarian hyperstimulation syndrome after controlled ovarian stimulation in a woman with systemic lupus erythematosus and lupus nephritis.
abstract: OBJECTIVE
  To report a case of late ovarian hyperstimulation syndrome (OHSS) in a woman with lupus nephritis undergoing controlled ovarian stimulation and in vitro fertilization (IVF) with subsequent transfer into a gestational surrogate.
  
  
  METHODS
  A case report.
  
  
  METHODS
  Academic reproductive medicine clinic.
  
  
  METHODS
  A 33-year-old woman who presented 10 days after recombinant human chorionic gonadotropin (hCG) injection with fatigue, abdominal pain, and bloating, diagnosed as OHSS.
  
  
  METHODS
  Patient admitted for intravenous fluid hydration, anticoagulation, and gonadotropin-releasing hormone (GnRH) antagonist therapy.
  
  
  METHODS
  Successful detection and management of severe OHSS in a patient with chronically impaired kidney function.
  
  
  RESULTS
  The patient has returned to her baseline condition, and the gestational carrier was noted to have a twin gestation.
  
  
  CONCLUSIONS
  In patients with impaired renal function, final oocyte maturation should be triggered with a GnRH agonist rather than hCG.
authors.affiliation: Division of Reproductive Endocrinology and Fertility, Department of Obstetrics and Gynecology, Duke University Hospital, Durham, North Carolina, USA. john.crochet@duke.edu
authors.forename: John R
authors.initials: JR
authors.lastname: Crochet
authors.forename: Jason S
authors.initials: JS
authors.lastname: Yeh
authors.forename: Megan E B
authors.initials: ME
authors.lastname: Clowse
authors.forename: Susannah D
authors.initials: SD
authors.lastname: Copland
mesh_terms: D000328:Adult; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000009:adverse effects; D006801:Humans; D007247:Infertility, Female / Q000209:etiology* / Q000628:therapy*; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000628:therapy; D008181:Lupus Nephritis / Q000150:complications* / Q000628:therapy; D016471:Ovarian Hyperstimulation Syndrome / Q000175:diagnosis* / Q000209:etiology; D010062:Ovulation Induction / Q000009:adverse effects*; D011247:Pregnancy; D011272:Pregnancy, Multiple; D013533:Gestational Carriers; D014427:Twins
chemical_list: D007987:Gonadotropin-Releasing Hormone