Le syndrome d’hyperstimulation ovarienne : physiopathologie, facteurs de risque, prévention et prise en charge

Lamazou, F.; Legouez, A.; Letouzey, V.; Grynberg, Michaël; Deffieux, X.; Trichot, C.; Fernandez, H.; Frydman, René

doi:10.1016/j.jgyn.2011.06.008

Cited by 24 publications

(8 citation statements)

References 231 publications

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“…Hyperestrogenemia also causes increased vascular permeability resulting in fluid extravasation into the third space and the development of hypoalbumin, ascites, pleural effusion and hemoconcentration [32]. Reduced venous return caused by enlarged ovaries, ascites and bed confinement may in part explain the cause behind the development of stroke [46]. Antiphospholipid antibodies syndrome, hypothyroidism, SLE and preexisting polycystic ovaries may also be associated with cerebrovascular events, which are recorded both in the literature review and in our cases.…”

Section: Discussionmentioning

confidence: 74%

“…In general, the following have been the therapeutic approaches: supportive measures, hydration, cortisone, anticoagulation (such as unfractioned heparin, low molecular weight heparin, warfarin) and antiplatelet treatment (e.g., aspirin and clopidogrel) [46]. Interventional treatments including intravascular local thrombolysis and thrombectomy should be reserved for patients with extensive or clinically deteriorating neurological deficits during conservative management.…”

Section: Discussionmentioning

confidence: 99%

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The Clinical Characteristics of Acute Cerebrovascular Accidents Resulting from Ovarian Hyperstimulation Syndrome

Yang

Yuan²,

Qin³

et al. 2017

Eur Neurol

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Background and Purpose: Ovarian hyperstimulation syndrome (OHSS) is a serious complication that occurs after the ovarian-induction treatment. Acute cerebrovascular accident is one of the most dangerous manifestations of the syndrome. However, the characteristics of stroke resulting from OHSS have so far not been well summarised in any study. Methods: We reported 2 cases of acute cerebrovascular accidents secondary to OHSS. And then we performed a literature search for reports on this type of stroke, and summarised their characteristics. Results: Thirty-six published cases of this type of stroke were reviewed. Thirty two out of 36 (88.9%) of the women were 35 years old or younger. Stroke in 28 out of 36 (77.8%) of these cases was caused by arterial thrombosis. In 17 out of 28 cases, the involved cerebral vascular branches were mainly middle cerebral artery (MCA) and internal carotid artery (ICA). The acute cerebrovascular accidents happened 7 and 9.25 days after embryo transplantation or 8 and 8.33 days after last human chorionic gonadotropin treatment respectively. The prognosis of patients was relatively good after anticoagulation and some supportive treatments. Conclusion: The MCA and ICA are easily involved in stroke resulting from OHSS. The young age may be a risk factor for developing stroke secondary to OHSS. Once thromboembolism develops, administering appropriate therapy is crucial.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

The Clinical Characteristics of Acute Cerebrovascular Accidents Resulting from Ovarian Hyperstimulation Syndrome

Yang

Yuan²,

Qin³

et al. 2017

Eur Neurol

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“…It caused by an acute shift of protein-rich fluid out of the intravascular compartment to the third space; it is the major medical complication of IVF with severe morbidity and probably mortality leading to enlarged ovaries and many other symptoms which differ depending on the stage [5]. The severe stage of OHSS in females who underwent ovarian stimulation for IVF has an incidence ranging 0, 5-2% [6].…”

Section: Discussionmentioning

confidence: 99%

OHSS Complicated With PID and Pelvic Abscess after IVF in a 35 Year Old Woman: A Case Report and Review of the Literature

Stavrou¹,

Domali²,

Loutradis³

et al. 2015

J Women’s Health Care

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Background: Ovarian hyper stimulation syndrome is an iatrogenic serious complication that presents after human chorionic gonadotropin stimulation or after the spontaneous peak of luteizing hormone. Pelvic inflammatory disease following the in vitro fertilization and oocyte retrieval is a rare and infrequent complication. Tubo-ovarian abscess has been described as rare and significant complication .We present an uncommon case according the literature in which rare complications of IVF are described. Methods:We present a case of a 35 year old female patient, gravida 1, para 0 with history of in vitro fertilization short protocol and oocytes retrieval before a month ,attended our hospital complaining for deep abdominal pain since 8 days with significant gynecological past history. Clinical evaluation proved abdominal pain on palpation without fever. Serum levels of C-reactive protein were significantly elevated reaching the plateau of 320,943. Results:Transvaginal ultrasonography noticed the presence of a big left adnexal formation max diameter 18 cm that could be attributed to marked inflammation. Behind this, free fluid detected by the presence of adhesions that could be attributed to hydrosalpinx. The diagnosis of ovarian hyper stimulation syndrome followed by pelvic inflammatory disease was made and she hospitalized for 10 days. The patient came to our hospital 3 months later for her follow up and the transvaginal examination revealed left tubo-ovarian abscess. A new transvaginal ultrasonography after 3 months was clearly improved compared to the previous images. Conclusion:Ovarian hyper stimulation syndrome which is complicated with pelvic inflammatory disease and especially pelvic abscess after in vitro fertilization and oocyte retrieval guided by ultrasound is a rare and simultaneously significant complication. Transvaginal ultrasonographical examination seems to be a pivotal tool primarily for the diagnosis and secondarily for the follow up of these infertile women.

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“…The risk is particularly prominent in women who are more likely to develop OHSS. The defined primary risk factors include young age, history of polycystic ovary syndrome, PCOS, a prior history of OHSS and any underlying thrombophilia [22]. Younger patients are more likely to have a robust response to ovarian stimulation increasing the risk for complications and development of OHSS.…”

Section: Risk Factorsmentioning

confidence: 99%

“…Younger patients are more likely to have a robust response to ovarian stimulation increasing the risk for complications and development of OHSS. A prior history of OHSS as well as a history of PCOS also increases the risk of OHSS [22,23]. Women with PCOS are also more likely to suffer this complication as they tend to produce more follicles.…”

Section: Risk Factorsmentioning

confidence: 99%

A Brief Review of Stroke associated with Assisted Reproductive Technology

O’Neal¹

2017

J Neurol Neurophysiol

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Strokes related to assisted reproductive technology are rare, but can be devastating. In order to understand how stroke can occur as a complication of assisted reproductive technology, both the normal physiology of ovulation and the hormonal manipulations used to maximize pregnancy will be examined. In particular, the danger of thrombotic complications related to ovarian hyperstimulation syndrome will be reviewed including the pathophysiology, clinical features, risk factors and treatment.

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Le syndrome d’hyperstimulation ovarienne : physiopathologie, facteurs de risque, prévention et prise en charge

Cited by 24 publications

References 231 publications

The Clinical Characteristics of Acute Cerebrovascular Accidents Resulting from Ovarian Hyperstimulation Syndrome

The Clinical Characteristics of Acute Cerebrovascular Accidents Resulting from Ovarian Hyperstimulation Syndrome

OHSS Complicated With PID and Pelvic Abscess after IVF in a 35 Year Old Woman: A Case Report and Review of the Literature

A Brief Review of Stroke associated with Assisted Reproductive Technology

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