Ovarian Hyperstimulation Syndrome in A Spontaneous Pregnancy After Cessation of A Long-Term Combined Oral Contraceptive Use: A Case Report

Year 2020, Volume: 9 Issue: 1, 45 - 48, 08.04.2020

Ayşe Nur Aksoy , Ebru Bulut Erdem Elcin Telli

https://doi.org/10.5505/abantmedj.2020.68926

Abstract

Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication of ovulation induction or controlled ovarian hyperstimulation. The OHSS frequently occurs due to the administration of human chorionic gonadotropin (hCG) in controlled ovarian hyperstimulation cycles. However, OHSS has been reported rarely in normal spontaneous pregnancy cases. In this paper, a case of mild OHSS at 10 weeks 5 days of gestation in a woman with singleton gestation, who conceived naturally after cessation of a long-term combined oral contraceptive use was reported. Patients using long-term oral contraceptive should be informed about the symptoms of OHSS for early diagnosis. Early diagnosis and appropriate supportive therapy are essential to avoid the potentially life-threatening complications of OHSS.

Keywords

ovarian hyperstimulation syndrome, combined oral contraceptive, pregnancy

Uzun süreli kombine oral kontraseptif kullanımının bırakılmasından sonra oluşan spontan bir gebelikte ovarian hiperstimülasyon sendromu: Bir olgu sunumu

Abstract

Ovarian hiperstimülasyon sendromu (OHSS), ovulasyon indüksiyonunun veya kontrollü ovarian hiperstimülasyonun iatrojenik bir komplikasyonudur. Ovarian hiperstimülasyon sendromu, kontrollü ovarian hiperstimülasyon sikluslarında insan koryonik gonadotropin (hCG) uygulamasından dolayı sıklıkla meydana gelir. Ancak, normal spontan gebelik vakalarında OHSS nadir olarak bildirilmiştir. Bu yazıda, uzun süreli kombine oral kontraseptif kullanımının kesilmesinden sonra spontan gebe kalan, tekil gebeliği olan bir kadında, 10 hafta 5 günlük gebelik haftasında orta şiddette OHSS vakası bildirilmiştir. Uzun süreli oral kontraseptif kullanan hastalar erken tanı için OHSS semptomları hakkında bilgilendirilmelidir. Erken tanı ve uygun destek tedavisi, OHSS'nin yaşamı tehdit edici komplikasyonlarından kaçınmak için esastır.

Keywords

ovarian hiperstimülasyon sendromu, kombine oral kontraseptif, gebelik

References

• Bhavsar PN, Padwal NJ, Bhide M, Ghagare SP, Joshi AR, Karnik ND. Life-threatening Medical Complications Due to Ovarian Hyperstimulation Syndrome: A Hidden Etiology. J Assoc Physicians India 2017; 65: 87-91.
• Eskew AM, Omurtag KR. Ovarian hyperstimulation syndrome management strategies: where are we going? Minerva Endocrinol 2018; 43: 50-6.
• Nelson SM. Prevention and management of ovarian hyperstimulation syndrome. Thromb Res 2017; 151: 61-4.
• Cabar FR. Ovarian hyperstimulation syndrome in a spontaneous singleton pregnancy. Einstein (Sao Paulo) 2016; 14: 231-4.
• Dey AK, Dubey A, Mittal K, Kale S. Spontaneous ovarian hyperstimulation syndrome understanding the dilemma. Gynecol Endocrinol 2015; 31: 587-9.
• Ozay C, Emekci O, Okyay RE, Gülekli B. Ovarian Hyperstimulation Syndrome. Turkiye Klinikleri J Gynecol Obst-Special Topics. 2015; 8: 112-5.
• Pinkas H, Sapir O, Avrech OM, Ben-Haroush A, Ashkenzi J, Fisch B, Farhi J. The effect of oral contraceptive pill for cycle scheduling prior to GnRH-antagonist protocol on IVF cycle parameters and pregnancy outcome. J Assist Reprod Genet 2008; 25: 29-33.
• Kim CH, You RM, Kang HJ, Ahn JW, Jeon I, Lee JW, Kim SH, Chae HD, Kang BM. GnRH antagonist multiple dose protocol with oral contraceptive pill pretreatment in poor responders undergoing IVF/ICSI. Clin Exp Reprod Med 2011; 38: 228-33.
• Pan JX, Liu Y, Ke ZH, Zhou CL, Meng Q, Ding GL, Xu GF, Sheng JZ, Huang HF. Successive and cyclic oral contraceptive pill pretreatment improves IVF/ICSI outcomes of PCOS patients and ameliorates hyperandrogenism and antral follicle excess. Gynecol Endocrinol 2015; 31: 332-26.