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Obstetrics & Gynecology 1999;93:809-811
© 1999 by The American College of Obstetricians and Gynecologists
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OBSTETRICS

SPONTANEOUS OVARIAN HYPERSTIMULATION AND PRIMARY HYPOTHYROIDISM WITH A NATURALLY CONCEIVED PREGNANCY

Conceição G. Cardoso, MD, Luis M. Graça, MD, PhD, Teresa Dias, MD, Nuno Clode, MD and Leonor Soares, MD

From the Departments of Obstetrics and Gynecology, Unit of Maternal-Fetal Medicine, and Medicine, Unit of Endocrinology, Santa Maria University Hospital, University of Lisbon Medical School, Lisbon, Portugal.

Address reprint requests to: Luis M. Graça R. Lucio Azevedo 19-6-ESQ 1600 Lisbon Portugal

Background: Ovarian hyperstimulation syndrome, not related to ovulation induction, is rare. A MEDLINE search from 1987 to 1997 using the key words "spontaneous ovarian stimulation," "pregnancy," and "hypothyroidism" revealed only five cases: three associated with pregnancies and two with primary hypothyroidism.

Case: A 25-year-old white gravida 2, para 1, at 11–12 weeks’ gestation presented with mild distension of a nontender abdomen, myxedematous facies, and large bilateral, multilobulated ovarian cysts. Conception had occurred spontaneously. Thyroid stimulating hormone was elevated, and free triiodothyronine and free thyroxine were low. Hypothyroidism, associated with spontaneous ovarian hyperstimulation syndrome, was diagnosed, and oral levothyroxine (0.10 mg/day) was started. With TSH still elevated at 21 weeks, levothyroxine was increased to 0.20 mg/day, and by 24 weeks, TSH and ovarian size were normal. Vaginal delivery of a 1120 g male infant occurred at 28 weeks.

Conclusion: A case of naturally conceived pregnancy associated with spontaneous ovarian hyperstimulation and primary hypothyroidism is reported.




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R. N. Edwards-Silva, C. S. Han, Y. Hoang, and L.-C. Kao
Spontaneous Ovarian Hyperstimulation in a Naturally Conceived Pregnancy With Uncontrolled Hypothyroidism
Obstet. Gynecol., February 1, 2008; 111(2): 498 - 501.
[Abstract] [Full Text] [PDF]


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