Unilateral pleural effusion as the main presentation of "early onset" severe ovarian hyperstimulation syndrome

OBJECTIVE: To report a case of severe early onset ovarian hyperstimulation syndrome with unilateral pleural effusion and little ascites as the main presenting clinical signs. DESIGN: Case report. SETTING: University affiliated teaching hospital and in vitro fertilization (IVF) clinic. PATIENT(S): A 33-year-old woman known to have bilateral polycystic ovaries underwent IVF and became pregnant. INTERVENTION(S): Pleuracentesis. MAIN OUTCOME MEASURE(S): Resolution of symptoms, pregnancy outcome. RESULT(S): A total of 4,200 mL of pleural fluid was drained from the right hemithorax. Complete resolution of symptoms did not occur until 16 weeks' gestation. The pregnancy progressed normally until 27 weeks when spontaneous preterm labor resulted in a vaginal delivery of a live female infant weighing 880 grams. CONCLUSION(S): This case described is unusual in that the patient presented with significant right-sided pleural effusions on day 2 after embryo transfer and continued to be symptomatic until 16 weeks' gestation. This is much earlier than any previously described case report of isolated unilateral pleural effusion associated with ovarian hyperstimulation syndrome.