Compressive pleural effusion after ovarian hyperstimulation syndrome--a case report and review.

OBJECTIVE: To report a case of early onset ovarian hyperstimulation with massive pleural effusion and respiratory failure before IVF.

DESIGN: Case report.

SETTING: University teaching intensive care unit.

PATIENT(S): A 26-year-old healthy woman with an unexplained infertility transferred to the intensive care unit on day 4 after hCG injection for early severe presentation of ovarian hyperstimulation syndrome with massive compressive pleural effusion before she underwent embryo transfer.

INTERVENTION(S): Mechanical ventilation, thoracocentesis.

MAIN OUTCOME MEASURE(S): Resolution of symptoms/stopping of embryos transfer.

RESULT(S): Drainage of 5,300 mL of sterile exudative pleural fluid for a period of 48 hours, which permitted resolution of symptoms and allowed mechanical weaning. The IVF procedure was stopped.

CONCLUSION(S): This case described is unusual in that the patient presented with early massive pleural effusion on day 4 after hCG injection and before embryo transfer. This is much earlier than in any case report elsewhere.