Document Detail


Persistent megalocystic ovary following in vitro fertilization in a postpartum patient with polycystic ovarian syndrome.
MedLine Citation:
PMID:  17272214     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Ovarian hyperstimulation syndrome (OHSS) is more severe when pregnancy occurs, as the developing pregnancy produces human chorionic gonadotropin, which stimulates the ovary's persistent growth. If no pregnancy occurs, the syndrome will typically resolve within 1 week. In a maintained pregnancy, slow resolution of symptoms usually occurs over 1-2 months. CASE REPORT: A 31-year-old woman, gravida 2, para 1, aborta 1, with polycystic ovary syndrome underwent in vitro fertilization (IVF) with clomiphene citrate and follicle-stimulating hormone/gonadotropin releasing hormone-antagonist stimulation. During transvaginal oocyte retrieval, enlarged bilateral ovaries were noted. She had an episode of OHSS after IVF/embryo transfer, for which paracentesis was performed three times. Pregnancy was achieved. Throughout antenatal examinations, bilateral ovaries were enlarged. She delivered a healthy baby by cesarean section at term. However, 1 month after delivery, the bilateral ovary had not shrunk, and levels of tumor markers CA125 and CA199 were 50.84 and 41.34 U/mL, respectively. At laparotomy for suspected malignancy, both adnexae formed "kissing ovaries", which were multinodulated with yellow serous fluid. Specimens from wedge resection submitted for frozen section showed a benign ovarian cyst. The final pathology report showed bilateral follicle cysts. CONCLUSION: With the increasing use of gonadotropins in the management of infertility, ovarian enlargement secondary to hyperstimulation is common. Generally, symptoms appear between the 6th and 13th weeks of pregnancy and disappear thereafter. The hyperstimulated ovary often subsides after the first trimester. This case is unusual as the megalocystic ovary persisted after delivery. To the best of our knowledge, we report the first case of enlarged bilateral ovaries persisting 2 months after delivery.
Authors:
Shin-Yee Ling; Kian-Mei Chong; Jiann-Loung Hwang
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Taiwanese journal of obstetrics & gynecology     Volume:  45     ISSN:  1875-6263     ISO Abbreviation:  -     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2007-02-02     Completed Date:  2007-03-15     Revised Date:  2007-12-28    
Medline Journal Info:
Nlm Unique ID:  101213819     Medline TA:  Taiwan J Obstet Gynecol     Country:  China    
Other Details:
Languages:  eng     Pagination:  70-2     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Adult
CA-125 Antigen / blood
Delivery, Obstetric
Embryo Transfer / adverse effects
Female
Fertilization in Vitro / adverse effects*
Humans
Infertility, Female / etiology*,  therapy*
Ovarian Hyperstimulation Syndrome / etiology*,  physiopathology
Ovulation Induction / adverse effects
Paracentesis
Polycystic Ovary Syndrome / complications*,  pathology,  surgery,  ultrasonography*
Postpartum Period
Pregnancy
Reoperation
Time Factors
Tumor Markers, Biological / blood
Chemical
Reg. No./Substance:
0/CA-125 Antigen; 0/Tumor Markers, Biological

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