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Clinical Conundrum: Spontaneous Ovarian Hyperstimulation Syndrome

  • Author Footnotes
    ∗ Shruti Agarwal and Diran Chamoun are co–first authors.
    Shruti Agarwal
    Correspondence
    Corresponding author: Shruti Agarwal
    Footnotes
    ∗ Shruti Agarwal and Diran Chamoun are co–first authors.
    Affiliations
    Camran Nezhat Institute, Minimally Invasive & Robotic Surgery, Woodside, CA
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  • Author Footnotes
    ∗ Shruti Agarwal and Diran Chamoun are co–first authors.
    Diran Chamoun
    Footnotes
    ∗ Shruti Agarwal and Diran Chamoun are co–first authors.
    Affiliations
    Viera Fertility Centre, Melbourne, FL
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  • Rebecca Flyckt
    Affiliations
    University Hospitals of Cleveland, Department of Obstetrics and Gynecology, Beachwood, OH
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  • Steven R. Lindheim
    Affiliations
    Department of Obstetrics and Gynecology, Boonshoft School of Medicine, Wright State University, Dayton, OH

    University of Central Florida College of Medicine, Department of Obstetrics and Gynecology, Orlando, FL

    Center for Reproductive Medicine Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
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  • Author Footnotes
    ∗ Shruti Agarwal and Diran Chamoun are co–first authors.
      A 31-year-old African American G0 female was referred for primary infertility for 18 months. Her history was significant for irregular menstrual cycles with new onset galactorrhea and 2 previous laparoscopic bilateral ovarian cystectomies. The patient was undergoing psychotherapy for severe depression/anxiety and was treated with escitalopram (Lexapro) 20 mg and bupropion (Wellbutrin) 100 mg daily. Her physical examination was significant for bilateral breast discharge. A transvaginal ultrasound (TVS) revealed normal endo/myometrial echoes and an asymmetric enlarged left ovary measuring 75 × 59 mm with multiple cysts measuring 47, 38, 33, and 20 mm, respectively, whereas the right ovary was unremarkable.

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