Severe OHSS is characterized by the presence of free intraperitoneal fluid. Pleural effusions, hypotension, and oliguria have also been described. Clinically, the patient may have fluid and electrolyte disturbances and is at increased risk for torsion of the enlarged ovaries. Serum estradiol levels are the most accurate indicator. The treatment of OHSS is often careful observation.
Some patients require hospitalization and supportive therapy.
If no pregnancy occurs, the syndrome will typically resolve within one week. In the setting of a maintained pregnancy, slow resolution of symptoms usually occurs over 1 to 2 months. This patient 's ovarian induction therapy was successful. A single intrauterine gestation has been followed into the second trimester and is progressing normally. The ovaries gradually returned to normal and the free fluid resolved.