{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T10:21:46Z","timestamp":1786702906808,"version":"build-2736575974"},"reference-count":20,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T00:00:00Z","timestamp":1695686400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program","doi-asserted-by":"publisher","award":["2021YFC2700605"],"award-info":[{"award-number":["2021YFC2700605"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program","doi-asserted-by":"publisher","award":["BYSYZD2021014"],"award-info":[{"award-number":["BYSYZD2021014"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Key Clinical Projects of the Peking University Third Hospital","award":["2021YFC2700605"],"award-info":[{"award-number":["2021YFC2700605"]}]},{"name":"Key Clinical Projects of the Peking University Third Hospital","award":["BYSYZD2021014"],"award-info":[{"award-number":["BYSYZD2021014"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Problem: Does the presence of hydrothorax suggest that severe ovarian hyperstimulation syndrome (OHSS) is associated with more severe conditions and worse pregnancy outcomes? Method of study: The clinical data for 868 hospital patients with severe OHSS following IVF-ET at Peking University Third Hospital between 1 January 2016 and 21 July 2021 were retrospectively analysed. The patients were divided into two groups, the ascites alone group (n = 417) and the ascites combined with hydrothorax group (n = 451), to investigate the clinical features and pregnancy outcomes of patients with severe ovarian hyperstimulation syndrome (OHSS) combined with hydrothorax plus ascites. Results: The clinical data for 868 hospital patients with severe OHSS following IVF-ET were included. A total of 51.96% of patients with severe OHSS had hydrothorax plus ascites, mainly bilateral and moderate hydrothorax. Most cases with hydrothorax could be monitored and observed, and only 2.66% of the cases required thoracentesis and pleural drainage. Clinically, the time to visit due to worsening symptoms was longer; the hospital stay was shorter; and the OHSS-related laboratory tests, such as white blood cells (WBC), haematocrit (HCT), and ovarian diameter, were less severe in the ascites combined with hydrothorax group than in the ascites alone group. For live-birth outcomes of IVF-ET, the presence and the volume of hydrothorax were not independent risk factors, while the late onset of OHSS (odds ratio [OR]: 0.857 95% confidence interval [CI]: 0.795, 0.925) and a history of foetal reduction (OR: 13.796 95% CI: 1.808, 105.288) were independent protective factors for live birth. Conclusions: Patients with severe OHSS combined with hydrothorax plus ascites have less severe clinical manifestations and laboratory tests than those with ascites alone. The presence and the volume of hydrothorax are unrelated to live-birth outcomes following in vitro fertilization and embryo transfer (IVF-ET).<\/jats:p>","DOI":"10.3390\/jcm12196210","type":"journal-article","created":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T08:58:17Z","timestamp":1695718697000},"page":"6210","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Clinical Features of Severe Ovarian Hyperstimulation Syndrome with Hydrothorax"],"prefix":"10.3390","volume":"12","author":[{"given":"Xiaowei","family":"Ma","sequence":"first","affiliation":[{"name":"Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China"},{"name":"National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China"},{"name":"Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing 100191, China"},{"name":"Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingwen","family":"Yin","sequence":"additional","affiliation":[{"name":"Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China"},{"name":"National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China"},{"name":"Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing 100191, China"},{"name":"Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Yang","sequence":"additional","affiliation":[{"name":"Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China"},{"name":"National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China"},{"name":"Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing 100191, China"},{"name":"Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuo","family":"Yang","sequence":"additional","affiliation":[{"name":"Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China"},{"name":"National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China"},{"name":"Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing 100191, China"},{"name":"Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Li","sequence":"additional","affiliation":[{"name":"Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China"},{"name":"National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China"},{"name":"Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing 100191, China"},{"name":"Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Wang","sequence":"additional","affiliation":[{"name":"Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China"},{"name":"National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China"},{"name":"Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing 100191, China"},{"name":"Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Li","sequence":"additional","affiliation":[{"name":"Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China"},{"name":"National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China"},{"name":"Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing 100191, China"},{"name":"Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,26]]},"reference":[{"key":"ref_1","unstructured":"Blumenfeld, Z. (2018). Vitamins and Hormones, Elsevier."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1634","DOI":"10.1016\/j.fertnstert.2016.08.048","article-title":"Prevention and treatment of moderate and severe ovarian hyperstimulation syndrome: A guideline","volume":"106","author":"Pfeifer","year":"2016","journal-title":"Fertil. Steril."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1016\/S0015-0282(98)00528-7","article-title":"Pulmonary manifestations of severe ovarian hyperstimulation syndrome: A multicenter study","volume":"71","author":"Abramov","year":"1999","journal-title":"Fertil. Steril."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1055\/s-0039-1695050","article-title":"Pleural Disease in Women","volume":"40","author":"Argento","year":"2019","journal-title":"Semin. Respir. Crit. Care Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1016\/S0015-0282(97)81383-0","article-title":"Markedly elevated cytokines in pleural effusion during the ovarian hyperstimulation syndrome: Transudate or ascites","volume":"67","author":"Randle","year":"1997","journal-title":"Fertil. Steril."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"S301","DOI":"10.1097\/01.CCM.0000182795.31757.CE","article-title":"Ovarian hyperstimulation syndrome","volume":"33","author":"Budev","year":"2005","journal-title":"Crit. Care Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.tjog.2011.01.014","article-title":"Update on management of ovarian hyperstimulation syndrome","volume":"50","author":"Chen","year":"2011","journal-title":"Taiwan J. Obstet. Gynecol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1016\/j.fertnstert.2003.09.042","article-title":"Prevalence of thrombophilia in women with severe ovarian hyperstimulation syndrome and cost-effectiveness of screening","volume":"81","author":"Reverter","year":"2004","journal-title":"Fertil. Steril."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1577","DOI":"10.1016\/j.ajem.2019.05.018","article-title":"Ovarian hyperstimulation syndrome: A review for emergency clinicians","volume":"37","author":"Timmons","year":"2019","journal-title":"Am. J. Emerg. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2425","DOI":"10.1183\/09031936.97.10102425","article-title":"Pleural effusion as a presenting symptom of ovarian hyperstimulation syndrome","volume":"10","author":"Man","year":"1997","journal-title":"Eur. Respir. J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/S0015-0282(16)57353-1","article-title":"Increased capillary permeability induced by human follicular fluid: A hypothesis for an ovarian origin of the hyperstimulation syndrome","volume":"63","author":"Goldsman","year":"1995","journal-title":"Fertil. Steril."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"3300","DOI":"10.1210\/jcem.87.7.8651","article-title":"Human chorionic gonadotropin-induced ovarian hyperstimulation syndrome is associated with up-regulation of vascular endothelial growth factor","volume":"87","author":"Wang","year":"2002","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1159\/000182995","article-title":"Right-sided hydrothorax complicating peritoneal dialysis. Report of 2 cases","volume":"34","author":"Grefberg","year":"1983","journal-title":"Nephron"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.jtcvs.2004.08.051","article-title":"The morphology of diaphragmatic defects in hepatic hydrothorax: Thoracoscopic finding","volume":"130","author":"Huang","year":"2005","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_15","first-page":"178","article-title":"Ovarian hyperstimulation syndrome and adverse pregnancy outcome: A systematic review and meta-analysis","volume":"74","author":"Buca","year":"2021","journal-title":"Minerva Obstet. Gynecol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1016\/S0015-0282(98)00350-1","article-title":"Obstetric outcome of in vitro fertilized pregnancies complicated by severe ovarian hyperstimulation syndrome: A multicenter study","volume":"70","author":"Abramov","year":"1998","journal-title":"Fertil. Steril."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.1016\/j.fertnstert.2010.12.015","article-title":"Obstetric outcome of women with in vitro fertilization pregnancies hospitalized for ovarian hyperstimulation syndrome: A case-control study","volume":"95","author":"Courbiere","year":"2011","journal-title":"Fertil. Steril."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Hu, L., Xie, R., Wang, M., and Sun, Y. (2021). Patients with IVF complicated by moderate-to-critical OHSS experience increased thrombosis, GDM and neonatal NICU admission but slightly shorter gestation compared with matched IVF counterparts: A retrospective Chinese cohort study. Reprod. Biol. Endocrinol., 19.","DOI":"10.1186\/s12958-020-00678-w"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"E971","DOI":"10.1210\/jc.2013-3794","article-title":"Apoptotic effects of high estradiol concentrations on endometrial glandular cells","volume":"99","author":"Chen","year":"2014","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.ogc.2013.10.005","article-title":"Inherited thrombophilias and adverse pregnancy outcomes: A review of screening patterns and recommendations","volume":"41","author":"Davenport","year":"2014","journal-title":"Obstet. Gynecol. Clin. N. Am."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/19\/6210\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:58:40Z","timestamp":1760129920000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/19\/6210"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,26]]},"references-count":20,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2023,10]]}},"alternative-id":["jcm12196210"],"URL":"https:\/\/doi.org\/10.3390\/jcm12196210","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,26]]}}}