"Ovarian stimulation in the hypothyroid child may result in oestrogen production, breast development, endometrial proliferation, and vaginal bleeding. It is likely that raised TSH concentrations bind and stimulate the FSH receptor, although a similar overlap phenomenon might occur at the level of the pituitary, with enhanced TRH production stimulating the GnRH receptor with subsequent ovarian enlargement. The cystic ovarian enlargement resolves with thyroid hormone replacement. A hyperstimulation phenomenon in patients with an abnormal FSH receptor has been described."
"Ovarian stimulation in the hypothyroid child may result in oestrogen production, breast development, endometrial proliferation, and vaginal bleeding. It is likely that raised TSH concentrations bind and stimulate the FSH receptor, although a similar overlap phenomenon might occur at the level of the pituitary, with enhanced TRH production stimulating the GnRH receptor with subsequent ovarian enlargement. The cystic ovarian enlargement resolves with thyroid hormone replacement. A hyperstimulation phenomenon in patients with an abnormal FSH receptor has been described."
"Ovarian stimulation in the hypothyroid child may result in oestrogen production, breast development, endometrial proliferation, and vaginal bleeding. It is likely that raised TSH concentrations bind and stimulate the FSH receptor, although a similar overlap phenomenon might occur at the level of the pituitary, with enhanced TRH production stimulating the GnRH receptor with subsequent ovarian enlargement. The cystic ovarian enlargement resolves with thyroid hormone replacement. A hyperstimulation phenomenon in patients with an abnormal FSH receptor has been described."
Expected headings
"Complications"
"The syndrome is relatively common, occurring in ~5% of patients undergoing in vitro fertilisation (IVF). There is probably an even higher incidence of the syndrome in "egg donors" due to their young age (which is a known risk factor for the disease), however, there is a known problem of lack of reporting of such cases."
"This syndrome is characterised by massive cystic ovarian enlargement and fluid shift from the intravascular compartment into the peritoneal, pleural or pericardial spaces. The vascular fluid leakage is thought to result from increased capillary permeability of mesothelial surfaces under the action of one or several vasoactive ovarian factors produced by multiple corpora lutea. Acute pelvic pain may result from stretching of the ovarian capsule or haemorrhage/rupture of a follicle."
"Imaging findings tend to be similar on ultrasound, CT and MRI."