Ovarian hyperstimulation syndrome (OHSS) is a potentially life-
threatening complication of IVF. We report a 33-year-old woman who
developed a large tubo-ovarian abscess and bilateral
hydroureteronephrosis following IVF, requiring urgent drainage and
multidisciplinary management.
Severe OHSS can rarely be complicated by tubo-ovarian abscess (TOA),
posing significant risk. This case represents an atypical but critical
complication of OHSS requiring multidisciplinary management.
Patient presented 5 days post-egg collection with abdominal pain, fever,
and vaginal bleeding. Imaging revealed a large TOA causing bilateral
hydroureteronephrosis.
CT-guided drainage was performed, aspirating 250 mL of purulent fluid.
Managed with IV antibiotics (piperacillin-tazobactam), no surgical
intervention needed.
Full recovery with resolution of hydroureteronephrosis. Follow-up
showed no recurrence.
Prompt imaging and drainage are key in managing OHSS complicated by
infection. This case highlights the importance of multidisciplinary care.
• Early detection and multidisciplinary management are critical.
• Imaging guides minimally invasive treatment.
• OHSS can have severe infectious and obstructive complications.
Keywords:
OHSS, tubo-ovarian abscess, IVF complications,
hydroureteronephrosis, CT-guided drainage.
References:
1. Rizk B, Aboulghar M. Classification, pathophysiology and management of OHSS. Hum Reprod. 1999.