THORACIC MANIFESTATIONS OF OVARIAN HYPERSTIMULATION SYNDROME

To determine the thoracic manifestations of severe ovarian hyperstimul ation syndrome, the major serious complication of induction of superov ulation with exogenous gonadotropins. PATIENTS AND METHOD: The authors reviewed the medical records and available images for 771 patients wh o had received gonadotropins to induce superovulation for in-vitro fer tilization and embryo transfer or intrauterine insemination of concent rated sperm. The patients, ranging in age from 28 to 43 years, had bee n treated between October 1990 and July 1992. RESULTS: In 22 patients (3%) severe hyperstimulation syndrome was diagnosed clinically and con firmed with ultrasonography. Pleural effusion occurred in five of thes e (23%), one of whom required thoracentesis. Atelectasis, associated w ith adult respiratory distress syndrome (ARDS) and internal jugular ve in thrombosis, developed in one patient, and ventilation-perfusion mis match of uncertain cause occurred in another. CONCLUSIONS: Respiratory distress in patients with ovarian hyperstimulation syndrome is most l ikely due to lung restriction caused by ascites, the large cystic ovar ies, or pleural or pericardial effusion. Pulmonary embolism and ARDS m ay rarely occur. Pulmonary manifestations, not previously well recogni zed, form an important part of this syndrome, and radiologic input wit h regard to assessment, monitoring and management are needed.