Endocrine Abstracts

Background: Spontaneous ovarian hyperstimulation syndrome (sOHSS) occurs rarely and has been associated with high level of human chorionic gonadotropin (HCG), mutated FSH receptor (FSHr) gene and hypothyroidism. We report sOHSS in two members of a family with autoimmune hypothyroidism.

Patient Findings: A 15 years old girl presented with abdominal pain and distention and typical features of hypothyroidism.Serum TSH was >100 mIU/l and anti-TPO antibody was 290 U/ml. Abdominal ultrasound and CT-scan revealed bilateral multilobulated ovarian cysts. FSHr gene sequencing showed no mutation. The second patient, the cousin of the first patient, a 14.5 years old girl was presented with acute abdominal pain and distention after a minor trauma. Hypothyroid feature was remarkable; laboratory test showed TSH: 72.5 mIU/l. Abdominal ultrasound revealed bilateral multilobulated ovarian cysts with one ruptured cyst. Levothyroxine therapy resulted in significant regression of ovarian cysts in both patients.

Conclusion: sOHSS can be simply managed with Levothyroxine in patients with hypothyroidism. However, its association with thyroid autoimmunity and puberty needs more investigation.

Keywords: Ovarian hyperstimulation syndrome, ovarian cyst, Hypothyroidism, Puberty, familial.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.