{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:40:06Z","timestamp":1756370406344,"version":"3.44.0"},"reference-count":22,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,7,5]]},"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:p>Ovarian hyperstimulation syndrome (OHSS) is a well-known iatrogenic complication of ovarian stimulation with gonadotropins. We present the case of a woman in her 30s who developed OHSS without the administration of gonadotropins. She was due to undergo intracytoplasmic sperm injection (ICSI) for primary subfertility. After taking a gonadotropin-releasing hormone (GnRH) receptor agonist for 3 weeks, she presented with abdominal pain, nausea and bloating. She was diagnosed with moderate to severe OHSS, requiring management as an inpatient.<\/jats:p>\n               <jats:p>Investigations included a pelvic ultrasound scan showing an enlarged ovary, serum oestradiol &gt;30\u2009000\u2009pmol\/L and an MRI of the brain with an incidental finding of a 5\u2009mm pituitary microadenoma.<\/jats:p>\n               <jats:p>She recovered rapidly and was referred for endocrinology evaluation and multidisciplinary team discussion. The OHSS was felt to be explained by an unusual \u2018flare\u2019 response to a GnRH agonist. A further ICSI cycle with an antagonist protocol is planned.<\/jats:p>","DOI":"10.1136\/bcr-2024-260512","type":"journal-article","created":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T22:55:14Z","timestamp":1721343314000},"page":"e260512","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Ovarian hyperstimulation syndrome without gonadotropin stimulation: an unusual response to a GnRH agonist"],"prefix":"10.1136","volume":"17","author":[{"given":"Sarah","family":"Petch","sequence":"first","affiliation":[{"name":"Gynaecology, Tallaght Hospital, Dublin, Ireland"},{"name":"The National Maternity Hospital, Dublin, Ireland"},{"name":"Merrion Fertility Clinic, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renato","family":"Bauman","sequence":"additional","affiliation":[{"name":"Merrion Fertility Clinic, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mensud","family":"Hatunic","sequence":"additional","affiliation":[{"name":"The National Maternity Hospital, Dublin, Ireland"},{"name":"Mater Misericordiae University Hospital, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cathy","family":"Allen","sequence":"additional","affiliation":[{"name":"The National Maternity Hospital, Dublin, Ireland"},{"name":"Merrion Fertility Clinic, Dublin, 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ovarian hyperstimulation syndrome in women at risk undergoing in vitro fertilization\/intracytoplasmic sperm injection treatment cycles: a randomized controlled study","volume":"5","author":"K\u0131l\u0131\u00e7","year":"2015","journal-title":"Avicenna J Med"},{"key":"2025082801155929000_17.7.e260512.13","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1016\/S1472-6483(10)60401-4","article-title":"Cabergoline reduces the early onset of ovarian hyperstimulation syndrome: a prospective randomized study","volume":"17","author":"Carizza","year":"2008","journal-title":"Reprod Biomed Online"},{"key":"2025082801155929000_17.7.e260512.14","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.1016\/j.fertnstert.2009.05.021","article-title":"High dose cabergoline in management of ovarian hyperstimulation syndrome","volume":"92","author":"Ata","year":"2009","journal-title":"Fertil 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