Journal of Education and Teaching in Emergency Medicine

Ovarian hyperstimulation syndrome (OHSS) is a rare but potentially life-threatening complication of assisted reproductive technology (ART). Prompt recognition and management are essential to reduce morbidity. This case describes a 30-year-old woman undergoing ART who presented to the emergency department (ED) with abdominal pain, distention, lightheadedness, nausea, vomiting, and shortness of breath following transvaginal oocyte retrieval. Physical examination revealed a tense, diffusely tender abdomen, and point-of-care ultrasound (POCUS) demonstrated enlarged ovaries bilaterally with multiple follicles and moderate peritoneal free fluid, confirming the diagnosis of OHSS. Laboratory findings included leukocytosis, hemoconcentration, and hypoproteinemia. The patient received supportive care with intravenous fluids and analgesia and, during admission, underwent therapeutic paracentesis, resulting in the removal of roughly three liters of ascitic fluid. Her symptoms resolved, and she was discharged on hospital day three with complete recovery noted at follow-up. This case highlights the diagnostic value of POCUS in the emergency setting for early identification of OHSS. As the use of ART increases, emergency clinicians should be aware of OHSS presentations and consider bedside ultrasound as a key diagnostic tool to expedite care and improve outcomes.