Spontaneous ovarian hyperstimulation in a pregnant woman with hypothyroidism

Objective: This report describes an unusual case in which a naturally conceived pregnancy is associated with spontaneous ovarian hyperstimulation and hypothyroidism. Design: Case report. Setting: University medical center. Patient(s): A 30-year-old pregnant woman with abdominal pain and distension caused by ovarian hyperstimulation. Intervention(s): Medical management and laparotomy. Main Outcome Measure(s): Incomplete regression after 3 months. Result(s): Thyroid-stimulating hormone level was elevated. Hormonal studies confirmed hypothyroidism with spontaneous ovarian hyperstimulation. She was given levothyroxine 200 mu g/d. Results of the hormonal tests for thyroid function were normal 3 months after treatment, but in this case the ovarian cysts did not regress completely until delivery. Laparotomy and cesarean section were done for both diagnosis and treatment. Ten weeks after delivery ovarian cysts regressed completely. Conclusion(s): Thyroid hormone replacement seems to be the best therapeutic approach in some patients, but, in some, complete resolution of the ovarian cysts does not occur after 3 months. (Fertil Steril (R) 2007;88:705. e1-3. (c) 2007 by American Society for Reproductive Medicine.)