A rare case report of persistent megalocystic ovaries with
adenomyosis years after ovarian stimulation

V S Thrupthi¹, Indira H^2*, Girish B L³

¹ Post Graduate, ² Professor and Head, ³ Professor, Department of Obstetrics & Gynaecology
Sri Siddhartha Medical College, SSAHE Tumkur
Karnataka India

* Corresponding author

Abstract
Background: Ovarian hyperstimulation syndrome (OHSS) is an excessive response to controlled ovarian hyperstimulation during treatment cycles(ovulation induction)which is used for assisted reproduction technology (ART). Ovarian torsion, 5thcommon emergency in gynaecology, is described as the partial or complete rotation of the ovarian vascular pedicle. Ovarian enlargement followed by IVF is generally bilateral, but torsion need not occur on both sides. Case presentation: A 37 year-old nulliparous presented to our hospital with pain abdomen. She had a history of laparoscopic myomectomy and puncture of para ovarian cysts 4 years back . She had 2 failed IVF cycles 6 years back. On Bimanual examination uterus corresponds to 24 weeks size. On ultrasound examination, uterus measuring 138x109x122mm with multiple intramural fibroids largest measuring 82x67mm in posterior wall with left complex cyst of size 82x64mm with right simple cyst of size 30x28mm. MRI showed adenomyosis with fibroids with enlarged bilateral ovaries with large well defined cysts and mild free fluid in Pouch of douglas. Her CA 125 is 146.7 U/ml. She has been counselled for surgery and intraoperative findings are uterus size of 24 weeks with bilateral pyosalpinx with megalocystic ovaries of size 7x6 cms (right ovary) and 8x6cms(left ovary).Specimen sent for HPE ,report showed adenomyosis with multiple leiomyomas ,chronic cervicitis, Luteoma with chronic oophoritis and torsion of right ovary, Theca lutein cyst with chronic oopharitis and torsion of left ovary, chronic salpingitis with areas of hemorrhage and congested blood vessels.
Keywords: OHSS, Luteoma, megalocystic ovaries, HCG, Thecalutein cyst.