Deep venous thrombosis and thromboembolic stroke resulting from severe ovarian hyperstimulation syndrome (OHSS) after in-vitro fertilization

Chinedu Nwaduru1, Shamsudeen Usman1*, Oluwademilade Adeniran1, Ifunanya Nwabueze1, Blessing Nebe1, Chinanu Obed-Okeke1
1St Nicholas Hospital, Lagos, Nigeria.
*Correspondence: Dr. Shamsudeen Usman; deenusmansan@gmail.com

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Abstract

Background: Ovarian Hyperstimulation Syndrome (OHSS) is a rare complication following hormonal therapy during ovulation induction, which can be life threatening in its severe forms. It can manifest in several ways and affect various systems in the body due to increased thrombotic events in the blood vessels. In its milder forms, patients with OHSS can be managed with both pharmacological and supportive treatments. However, severe forms of OHSS especially cerebrovascular complications, have often proven fatal resulting in severe functional impairments and increased mortality.
Case description: In this report, we review a young woman with background PCOS who presents with OHSS following hormonal induction therapy. Despite pharmacological and supportive management, she eventually developed a stroke in the right cerebral hemisphere following a popliteal and femoral DVT leading to neurological impairment including left facial palsy and left hemiparesis. Significant clinical improvement was observed upon commencement of anti-coagulants, statins and physical therapy and patient was discharged afterwards. Unfortunately, further progress could not be ascertained as patient was lost to follow-up.
Conclusion: Acute ischemic stroke must be considered in females with neurological dysfunction and recent ovarian stimulation.

Keywords: Deep venous thrombosis, Thromboembolic stroke, Ovarian Hyperstimulation Syndrome, Assisted reproductive technology, Ovulation induction.

Cite this article: Nwaduru C, Usman S, Adeniran O, Nwabueze I, Nebe B, Obed-Okeke C. Deep venous thrombosis and thromboembolic stroke resulting from severe ovarian hyperstimulation syndrome (OHSS) after in-vitro fertilization. Yen Med J. 2022;4(2):34–39.

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