*Learning Objectives:
1) Background- Incidence, risk factors, and causes for OHSS will be discussed (including relationship to IVF), along with patient presentation.
2) Cases - Cases of OHSS will be presented including imaging findings for each case.
3) Management - Different clinical management for patients with OHSS, the role of radiologists in guiding management, and potential complications will be discussed.

*Content Description:
Epidemiology, incidence, risk factors, causes for OHSS, and relationship to IVF will be discussed.
Cases will be presented:
Case 1: A 34-year old female presented to the ED with distended abdomen and “ a feeling like her ribs are breaking”, one day status post egg retrieval. The patient initially received a pelvic ultrasound which revealed enlarged cystic ovaries with pelvic free fluid. A subsequent CT of the abdomen and pelvis demonstrated bilateral enlargement of the ovaries with multiple cysts and small amount of hemoperitoneum in the deep pelvis, consistent with ovarian hyperstimulation syndrome Golan grade 3.
Case 2: A 35-year old female presented to the ED with left pelvic pain and left upper thigh/groin pain. She had an egg retrieval about one week ago. With history of DVT, the patient initially received an ultrasound duplex scan for bilateral lower extremities, which was negative. A subsequent CT of the abdomen and pelvis demonstrated enlarged ovaries with bilateral ovarian cysts. On ultrasound, she was found to have multiple follicles in enlarged bilateral ovaries and a complex cyst on the left ovary. There was no vascular compromise. Case 3: A 25-year old female was sent to the ED for left lower quadrant abdominal pain with radiation to the left flank along with a fever. She had recently undergone egg retrieval. On US, she was found to have markedly enlarged ovaries with multiple prominent follicles. On CT, there was no obstructing kidney stone(s). She was found to have a left retro hemoperitoneum.
Clinical management, role of radiologists, and potential complications will be discussed.

Victoria Kim MD

Rutgers Health/Monmouth Medical Center

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