Open AccessSevere ovarian hyperstimulation syndrome in a 42‐year‐old woman with successful pregnancy after intracytoplasmic sperm injection embryo transfer
Author(s) -
SHIBAHARA HIROAKI,
SHIMADA KAZUHIKO,
MORIMATSU YUKAKO,
KIKUCHI KUMIKO,
HIRANO YUKI,
SUZUKI TATSUYA,
TAKAMIZAWA SATORU,
SUZUKI MITSUAKI
Publication year - 2005
Publication title -
reproductive medicine and biology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.005
H-Index - 22
eISSN - 1447-0578
pISSN - 1445-5781
DOI - 10.1111/j.1447-0578.2005.00112.x
Subject(s) - ovarian hyperstimulation syndrome , intracytoplasmic sperm injection , medicine , polycystic ovary , pregnancy , embryo transfer , gestation , gynecology , assisted reproductive technology , ovulation induction , polycystic ovarian disease , obstetrics , in vitro fertilisation , ovulation , infertility , endocrinology , biology , diabetes mellitus , genetics , insulin resistance , hormone
Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication of ovulation induction for infertile women. It has been shown that patients suffering from OHSS are generally young because OHSS depends on the patient's ovarian reserve. Therefore, women ≥40 years of age seldom suffer from the severe form of OHSS. In the present study, we report a case of severe OHSS that occurred in a 42‐year‐old woman with a successful pregnancy after intracytoplasmic sperm injection (ICSI)‐embryo transfer. She had been diagnosed as having polycystic ovary syndrome (PCOS). After 5 cycles of unsuccessful treatment with gonadotropins plus intrauterine insemination for her husband's asthenozoospermia, the treatment with assisted reproductive technology (ART) was indicated. In the third ART attempt, the patient was treated by ICSI‐embryo transfer (ET) and she developed severe OHSS at 4 weeks’ gestation. On admission, marked hemoconcentration, oligouria and hypo‐albuminemia were diagnosed. A continuous autotransfusion system of ascites, which was developed to expand circulating plasma volume without exogenous albumin, was carried out for 5 h at a rate of 100–200 mL/h once a day for a total of 5 days. The course of the pregnancy was uneventful. At 37 weeks’ gestation, a healthy baby boy weighing 3336 g was born by cesarean section when the patient was 43 years of age. The postoperative course was also uneventful. To the best of our knowledge, the present report describes the oldest woman showing severe OHSS. (Reprod Med Biol 2005; 4 : 265–269)