Spontaneous ovarian hyperstimuation syndrome in a naturally conceived singleton pregnancy

Ovarian torsion and spontaneous ovarian hyperstimulation syndrome in a twin pregnancy: A case report

“…Recently, mutations of the FSHR gene leading to an increased sensitivity of the receptor to normal levels of hormones have been also described [1], [2], [4], [8], although a standard genetic test has yet to be developed. Several circumstances may increase the levels or biological activity of these glycoproteins:

Elevated endogenous levels of hCG can be seen in multiple pregnancies and gestational trophoblastic disease [2].

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“…Several circumstances may increase the levels or biological activity of these glycoproteins:

Elevated endogenous levels of hCG can be seen in multiple pregnancies and gestational trophoblastic disease [2]. A variant of β-hCG with higher biological activity could also cause hyperstimulation of the FSHR [1], [8].

High TSH levels are seen in primary hypothyroidism [4], [8] and more rarely in TSH-secreting adenomas [1], [3], [5], [8]. Patients with spontaneous OHSS related to TSH can be treated with thyroid hormone replacement therapy, so they have a better prognosis [5], [8].…”

“…Normally iatrogenic, OHSS mainly occurs in the context of infertility treatments and is extremely rare in spontaneous pregnancies [1], [2], [3], [4], [5]. In contrast with iatrogenic forms, which typically appear earlier [2], [4], [6], [7], spontaneous OHSS usually develops between the 8th and 14th weeks of gestation; it is sometimes familial and recurrent [6], and it can occur in non-pregnant women [5], [7], [8].…”

“…Common risk factors for developing spontaneous OHSS include age <35 years, low body weight, polycystic ovarian syndrome, and previous episodes of spontaneous OHSS [1], [4].…”

Laparoscopic detorsion for bilateral ovarian torsion in a singleton pregnancy with spontaneous ovarian hyperstimulation syndrome

“…[1] Although the majority of OHSS cases are iatrogenic, spontaneous OHSS (SOHSS), a very rare event, has also been reported. [2] Although SOHSS almost always occurs in conjunction with pregnancy, the actual incidence still remains obscure. SOHSS usually develops between 8 and 14 weeks of gestational age, possibly due to a mutated follicular stimulating hormone (FSH) receptor, which shows abnormal sensitivity to human chorionic gonadotropin (hCG) or due to wild type of FSH with abnormally high levels of hCG.…”