• Clinical and Experimental Reproductive Medicine
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• v.36 no.2
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• pp.137-142
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• 2009

Ovarian hyperstimulation syndrome (OHSS) is one of the most common iatrogenic complications induced by assisted reproductive technology. Hydrothorax develops in about 10 percent of patients with severe OHSS and it is usually associated with marked ascites. On the other hand, severe hydrothorax without marked ascites is uncommon, and its pathogenesis remains unclear. We recently experienced a case of severe unilateral hydrothorax with minimal ascites induced by quintuplet pregnancy following intrauterine insemination with controlled ovarian hyperstimulation. Severe hydrothorax was resolved after only conservative and symptomatic management without invasive procedure such as thoracentesis or paracentesis. We report this case with brief review of literature.

• Clinical and Experimental Reproductive Medicine
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• v.37 no.4
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• pp.293-305
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• 2010

Ovarian hyperstimulation syndrome (OHSS) is a life-threatening iatrogenic complication of ovulation induction. Before ovarian stimulation, identification of patients vulnerable to developing OHSS is necessary. And ovarian stimulation should be started with low doses of gonadotropin or GnRH antagonist protocol. During monitoring of ovarian stimulation with risk of OHSS, coasting, low doses hCG and GnRH agonist for triggering ovulation are considered. If severe OHSS is predicted, cycle cancellation and cryopreservation of all embryos should be considered to reduce late-onset OHSS and morbidity. And metformin and dopamine agonist for reducing OHSS are being proposed as a prophylactic treatment for OHSS.

• Clinical and Experimental Reproductive Medicine
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• v.35 no.1
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• pp.83-88
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• 2008

Thromboembolic disease associated with assisted reproductive techniques is considered to be extremely rare but most serious complication. The reasons for this are thought to hypercoagulable state characteristic of OHSS due to high serum levels of estrogen, hemoconcentration and reduced circulating blood volume, but is still unclear. The risk is increased those with rare hypercoagulable conditions such as antiphospholipid antibody syndrome, protein C deficiency, protein S deficiency, antithrombin III deficiency, and those with a personal or family history of thromboembolic disease. The majority of thrombosis reported were venous site but arterial thrombosis mostly intracerebral was reported 5 cases in Korea so far. We present a case of basilar a. thrombosis at 11 days after hCG injection. The patient developed the right hemiparesis, and recovered after intraarterial thrombolysis and transluminal angioplasty. Protein S activity was decreased and vWF antigen was increased. Decreased protein S activity was also found in previous reported 4 cases, so we suggest screening test for protein S in OHSS patients.

• 대한생식의학회:학술대회논문집
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• 2006.11a
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• pp.121.1-121.1
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• 2006

• 대한생식의학회:학술대회논문집
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• 2002.11a
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• pp.68-69
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• 2002

• Tuberculosis and Respiratory Diseases
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• v.44 no.3
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• pp.684-691
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• 1997

1be ovarian hyperstimulation syndrome is a rare but serious complication of ovulation induction therapy with gonadotropin. The clinical manifestations are generalized edema, ascites with pleural effusion and may become life-threatening in severe cases. The pathophysiology is still unknown, therefore, the treatment should be symptomatic and conservative. We report a case of severe OHSS with massive right pleural effusion in excess of ten liters after human menopausal gonadotropin therapy because of secondary infertility. Fluid and electrolyte imbalances were corrected and albumin was administered. A right chest tube was placed for a total of sixteen days, draining eleven liters of pleural effusion totally, resulting a dramatic decrease of pleural effusion and improvement of symptoms.

• Tuberculosis and Respiratory Diseases
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• v.50 no.5
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• pp.636-640
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• 2001

Ovarin hyperstimulation syndrome (OHSS), an iatrogenic complication of ovarian stimulation, shows varying degrees of clinical manifestations. The pathogenesis of OHSS is an increase of vascular permeability resulting in hypovolemia, thromboembolism, ARDS, and death in sometimes. Pleural effusion is also a result of an increase of vascular permeability in the pleura. Thoracentesis is sometimes required to relieve dyspnea. We report a case of OHSS with bilateral exudative pleural effusion in a 23 year-old female with resting dyspnea. She was received clomiphen, FSH, and LH for the treatment of irregular menstruation twenty days previously. The ultrasonogram showed severe ascites and bilaterally huge ovary, and chest radiography showed bilateral effusion. Therapeutic thoracentesis and paracentesis were done for relief of the dyspnea. Two weeks later the bilataral effusion and symptoms disappeared spontaneously.

• The Journal of Korean Obstetrics and Gynecology
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• v.27 no.4
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• pp.141-149
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• 2014

Objectives: The purpose of this study is to report the effects of herbal medicine and acupuncture on ovarian hyperstimulation syndrome (OHSS). Methods: A patient who had OHSS with edema and pain of left leg as chief complaints was treated by herbal medicne and acupuncture for 11days. We evaluated the results of treatment by change of symptoms, circumference of left leg, Visual Analogue Scale about left leg pain and walking time. Results: After treatment, symptoms of OHSS were almost improved. Circumference and pain of left leg were reduced and walking time was incresed after treatment. Conclusions: This study suggests that Korean medicine mainly herbal medicine and acupuncture is effective on OHSS.

• Clinical and Experimental Reproductive Medicine
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• v.34 no.1
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• pp.49-56
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• 2007

Objective: To evaluate the effect of short coasting, by withdrawing both gonadotropins and GnRH agonist (GnRHa), on the prevention in severe ovarian hyperstimulation syndrome(OHSS) without compromising pregnancy outcome. Method: Thirty-seven women who had been coasted during COH for IVF were coasted when $\geq$20 follicles > 15 mm with serum E$_2$ level of 4,000 pg/ml were detected. Coasting was initiated for one or two days depending on the status of follicle on ultrasound and serum E$_2$ level. Both gonadotropin and GnRHa were withheld for coasting. Retrospective study was carried and changes of serum E$_2$ levels, number of oocytes retrieved, fertilization rate, pregnancy rate were compared and analyzed. Results: The mean serum E$_2$ level fell from 6,993 pg/ml on the onset of coasting to 3,396 pg/ml on the day of hCG administration. The mean number of oocytes retrieved and fertilization rate were 15.7 and 70.0%, respectively. Fifteen patients were pregnant (40.6%) and implantation rate was 15.2%. Twenty-six (70.3%) patients were coasted for one day and 11 (29.7%) were coasted for two days. The mean decrease rate of serum E$_2$ level was 43% in one day coasting group and 15% (1$^{st}$ day) and 81% (2$^{nd}$ day) in two day coasting group. The pregnancy outcome was similar between the two groups. After coasting, no severe or moderate OHSS occurred in any patients and mild OHSS occurred in 3(8.1%) patients. Conclusions: Coasting for one or two days can be used successfully in the prevention of OHSS without compromising IVF cycle outcome.

• The Journal of Korean Obstetrics and Gynecology
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• v.31 no.2
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• pp.103-112
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• 2018

Objectives: The aim of this paper is to report that herb medicine effects on four infertility patients with ovarian cysts and the menstrual irregularity as a result of ovarian hyperstimulation syndrome. Methods: Four infertility patients with ovarian cysts had the same symptom of menstrual irregularity for preparing In Vitro Fertilization (IVF). They were treated by twice a day herb medication Changbudodam-tang. Then we observed the effects of treatments by regularity of menstruation, checking with ultrasonography of ovarian cyst size. Results: After herb treatments, the sizes of ovarian cysts decreased and one of them disappeared. Above all, menstrual regularity was recovered for preparing IVF. So they could have a positive progress of IVF. Conclusions: These cases show that herb medicine has its effective treatments for the implantational surroundings on infertility patients with ovarian cyst and menstrual irregularity because of ovarian hyperstimulation syndrome.