Ovarian hyperstimulation syndrome (OHSS)

Clinical syndrome generally associated with ovulation induction

Bilaterally enlarged, cystic ovaries

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  Heterogeneous complex ovarian cysts with debris and septa if hemorrhagic component present

  
  
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  Typical spoke-wheel appearance

Ascites

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  Occasionally, will find hemorrhagic pelvic fluid

Pleural effusion

Theca lutein cysts

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  Not associated with ascites, pleural effusions, or oliguria

Hyperreactio luteinalis

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  More mild, indolent course within spectrum of OHSS

Cystic ovarian neoplasm

Exaggerated response to ovulation induction

Relative hemoconcentration due to fluid leaking into peritoneal/pleural spaces

Typical clinical symptoms

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  Abdominal pain

  
  
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  Nausea/vomiting/diarrhea

  
  
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  Weight gain

  
  
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  Oliguria

Should be self-limiting as long as supportive care started early in process

Avoid aggressive transvaginal imaging, as ovaries can be friable