Continuous abdominal paracentesis for management of late type severe ovarian hyperstimulation syndrome

The ovarian hyperstimulation syndrome (OHSS) is often observed in patients undergoing assisted reproductive technology (ART). In severe form OHSS is a serious and potentially life-threatening. Here we report a 36-year-old woman with primary infertility due to endometriosis who underwent controlled ovarian hyperstimulation. Ten days later, severe late-onset ovarian hyperstimulation syndrome, severe ascites and pulmonary effusion, developed. Continuous abdominal paracentesis of 5000 mL/day was performed on the third day. With this procedure, ascitic fluid was drained efficiently and the patient's condition improved. This report suggests that early continuous abdominal paracentesis with drainage of ascitic fluid is an efficacious procedure for management of the severe ovarian hyperstimulation syndrome as soon as euvolemia is achieved clinically.