Ovarian Hyperstimulation Syndrome: An Unusual Cause of Abdominal Pain Presenting to the Emergency Department

The use of assisted reproductive technologies (ART), such as in vitro fertilization (IVF), is steadily increasing. Ovarian hyperstimulation syndrome (OHSS) is a rare but potentially serious complication arising from controlled ovarian hyperstimulation (COH), a critical component of ART. OHSS may vary in severity and usually causes abdominal pain, nausea, vomiting, diarrhea, and dyspnea, which are common complaints for patients presenting to the emergency department (ED). Preventive measures and early recognition by reproductive medicine specialists generally reduce the incidence of severe OHSS, making ED presentations uncommon. However, patients may present to the ED and require the ED physician to provide initial evaluation and management. The patients often require admission to the hospital and may be cared for by physicians who are not reproductive medicine specialists. This case report describes a 35-year-old woman who developed severe abdominal pain following oocyte retrieval and oocyte pick-up at a fertility clinic and subsequently presented to the ED for evaluation. The report highlights the diagnosis and management of OHSS, incorporating current literature and guideline recommendations, particularly for non-reproductive medicine specialists, such as ED physicians and hospitalists, who may need to care for patients with this complication.