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Case report
Severe early-onset ovarian hyperstimulation syndrome with liver dysfunction in an IVF segmentation cycle
  1. Neeta Singh,
  2. Yogita Dogra,
  3. Monika Saini and
  4. Matheswari Govindarajan
  1. Obstetrics & Gynecology, All India Institute of Medical Sciences, New Delhi, India
  1. Correspondence to Dr Yogita Dogra; dryogitadogra{at}


Severe early-onset ovarian hyperstimulation syndrome (OHSS) with deranged liver function tests is an entity that cannot be eliminated wholly even after gonadotropin-releasing hormone (GnRH) agonist trigger without any luteal human chorionic gonadotropin (hCG) rescue in a GnRH antagonist protocol with the freeze-all approach. We describe a case of young polycystic ovary syndrome patient with prior history of severe early-onset OHSS in her last in vitro fertilisation cycle in which she received antagonist protocol followed by blastocyst transfer. Given her history, she was planned for agonist trigger and freeze all approach during the present cycle. Despite segmentation of the cycle without any luteal rescue hCG, she developed early-onset severe OHSS with markedly deranged liver function tests for which she underwent ascitic tapping and remained hospitalised for 8 days. Her symptoms improved with conservative management, and she was discharged satisfactorily. She underwent letrozole based frozen–thawed embryo transfer cycle after 4 months. One good quality blastocyst was transferred, and she conceived in the same cycle.

  • reproductive medicine
  • pregnancy

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  • Contributors Substantial contributions to the acquisition and interpretation of data: NS, YD. Drafting the work for important intellectual content: NS, YD, MS, MG. Final approval of the version published: NS, YD, MS, MG. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: NS, YD, MS, MG.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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