Unsuspected adverse effect of albumin in severe ovarian hyperstimulation syndrome: a case report

Ovarian hyperstimulation syndrome (OHSS) is one of the most serious complications of in vitro fertilization (IVF). We present a case of OHSS maintained and aggraved by albumin administration. A 29-year-old woman with severe OHSS was treated with albumin perfusion according to the guidelines. The albumin was administered in order to maintain intravascular oncotic pressure and to reverse the shift of fluid from the intravascular to the third space, but this therapeutic measure resulted in inadvertent maintenance of the syndrome. The treatment of OHSS is a delicate balance between invasive approaches, such as paracentesis, administration of colloids and minimal therapeutic intervention, particularly during pregnancy.