{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T16:03:01Z","timestamp":1782316981389,"version":"3.54.5"},"reference-count":24,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,1,19]]},"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:p>Severe early-onset ovarian hyperstimulation syndrome (OHSS) with deranged liver function tests is an entity that cannot be eliminated wholly even after gonadotropin-releasing hormone (GnRH) agonist trigger without any luteal human chorionic gonadotropin (hCG) rescue in a GnRH antagonist protocol with the freeze-all approach. We describe a case of young polycystic ovary syndrome patient with prior history of severe early-onset OHSS in her last in vitro fertilisation cycle in which she received antagonist protocol followed by blastocyst transfer. Given her history, she was planned for agonist trigger and freeze all approach during the present cycle. Despite segmentation of the cycle without any luteal rescue hCG, she developed early-onset severe OHSS with markedly deranged liver function tests for which she underwent ascitic tapping and remained hospitalised for 8\u2009days. Her symptoms improved with conservative management, and she was discharged satisfactorily. She underwent letrozole based frozen\u2013thawed embryo transfer cycle after 4\u2009months. One good quality blastocyst was transferred, and she conceived in the same cycle.<\/jats:p>","DOI":"10.1136\/bcr-2019-233379","type":"journal-article","created":{"date-parts":[[2020,1,27]],"date-time":"2020-01-27T04:55:16Z","timestamp":1580100916000},"page":"e233379","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Severe early-onset ovarian hyperstimulation syndrome with liver dysfunction in an IVF segmentation cycle"],"prefix":"10.1136","volume":"13","author":[{"given":"Neeta","family":"Singh","sequence":"first","affiliation":[{"name":"Obstetrics & Gynecology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yogita","family":"Dogra","sequence":"additional","affiliation":[{"name":"Obstetrics & Gynecology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Saini","sequence":"additional","affiliation":[{"name":"Obstetrics & Gynecology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matheswari","family":"Govindarajan","sequence":"additional","affiliation":[{"name":"Obstetrics & Gynecology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,1,26]]},"reference":[{"key":"2025082709483086000_13.1.e233379.1","first-page":"20","article-title":"Gnrh antagonist IVF protocol in PCOS","volume":"39","author":"Onofriescu","year":"2013","journal-title":"Curr Health Sci J"},{"key":"2025082709483086000_13.1.e233379.2","doi-asserted-by":"crossref","first-page":"765","DOI":"10.6061\/clinics\/2015(11)09","article-title":"Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice","volume":"70","author":"Melo","year":"2015","journal-title":"Clinics"},{"key":"2025082709483086000_13.1.e233379.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2003.10.004"},{"key":"2025082709483086000_13.1.e233379.4","doi-asserted-by":"crossref","first-page":"149","DOI":"10.22551\/2016.13.0304.10085","article-title":"Ovarian hyperstimulation syndrome after GnRH agonist trigger and rhCG luteal rescue protocol","volume":"03","author":"Maftei","year":"2016","journal-title":"Archive of Clinical Cases"},{"key":"2025082709483086000_13.1.e233379.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2014.01.019"},{"key":"2025082709483086000_13.1.e233379.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2014.07.022"},{"key":"2025082709483086000_13.1.e233379.7","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dem254"},{"key":"2025082709483086000_13.1.e233379.8","doi-asserted-by":"publisher","DOI":"10.4103\/0974-1208.86080"},{"key":"2025082709483086000_13.1.e233379.9","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2007-0409"},{"key":"2025082709483086000_13.1.e233379.10","doi-asserted-by":"crossref","unstructured":"Tang H , Hunter T , Hu Y , et al . 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