Spontaneous ovarian hyperstimulation syndrome and hyperreactio luteinalis are entities in continuum

Area of Science:

• Reproductive Endocrinology
• Obstetrics and Gynecology

Background:

• Hyperreactio luteinalis (HL) and spontaneous ovarian hyperstimulation syndrome (OHSS) are rare but significant conditions in pregnancy.
• Both conditions present with enlarged, multicystic ovaries and ascites, mimicking ovarian carcinoma.
• Differentiating between HL and spontaneous OHSS is clinically challenging but crucial for appropriate management.

Observation:

• A 32-year-old woman presented at 13 weeks of spontaneous gestation with markedly enlarged multicystic ovaries and ascites.
• Advanced imaging, including ultrasonography and MRI, was utilized to assess ovarian status and exclude malignancy.
• The patient received conservative, supportive therapy throughout her pregnancy.

Findings:

• The patient successfully delivered a healthy infant at term.
• The case underscores the diagnostic challenges posed by HL and spontaneous OHSS during pregnancy.
• Supportive management was effective, leading to a favorable maternal and fetal outcome.

Implications:

• Increased use of ultrasonography may lead to more frequent detection of multicystic ovaries in spontaneous pregnancies.
• While distinguishing HL from spontaneous OHSS can be difficult, the treatment approach remains consistent.
• This case emphasizes the importance of imaging modalities in non-surgical management and differential diagnosis of ovarian enlargement in pregnancy.