title: Ovarian stimulation and liver dysfunction: Is a clinical relationship possible? A case of hepatic failure after repeated cycles of ovarian stimulation.
abstract: Liver damage induced by ovarian stimulation has been demonstrated in some cases reported in the literature. However, there has never been a fruitful debate on this topic. The present manuscript tried to fill this gap. We reported a case of a 35-year-old nulliparous woman admitted to our obstetric emergency room for severe pre-eclampsia. She had been subjected to four cycles of controlled ovarian stimulation for intrauterine insemination. At 32 weeks of gestation, she developed severe pre-eclampsia, which led to HELLP syndrome complicated by fatal liver failure. The etiological link between ovarian stimulation and HELLP syndrome is intriguing. Further investigations are needed to understand whether repeated ovarian stimulation may represent a risk factor in pre-eclamptic patients.
authors.affiliation: Department of Biomedical Sciences and Advanced Therapies, University of Ferrara, Ferrara, Italy.
authors.forename: Emilio
authors.initials: E
authors.lastname: Giugliano
authors.forename: Elisa
authors.initials: E
authors.lastname: Cagnazzo
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Pansini
authors.forename: Fortunato
authors.initials: F
authors.lastname: Vesce
authors.forename: Roberto
authors.initials: R
authors.lastname: Marci
keywords: Controlled ovarian stimulation; Endothelial dysfunction; HELLP syndrome; Intrauterine insemination; Liver rupture; Ovarian hyperstimulation syndrome