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Santistevan L, Lonergan D, Eyvazzadeh AD. First case report of serous otitis media as a complication of severe ovarian hyperstimulation syndrome: Case report and literature review. Int J Gynaecol Obstet 2024; 164:843-847. [PMID: 37525483 DOI: 10.1002/ijgo.15022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 05/26/2023] [Accepted: 07/10/2023] [Indexed: 08/02/2023]
Abstract
Ovarian hyperstimulation syndrome (OHSS) may be a severe complication of controlled ovarian hyperstimulation during assisted reproductive technology. During OHSS, fluid shifts from the intravascular space to the third-space compartments as the result of an increase in capillary permeability. This can cause fluid accumulation in peritoneal as well as thoracic cavities. The patient presented with symptoms of severe OHSS (bilateral hydrothorax and pulmonary effusion), requiring bilateral ultrasound-guided paracentesis and bilateral thoracentesis during her Emergency Room visits and hospitalization. Due to distant effects from the increased capillary permeability, the patient presented fluid in the middle ear, which led to the development of serous otitis media 12 days after egg retrieval. This was resolved 2-3 weeks later after being treated with antihistamines and antibiotics given by her Ear, Nose, and Throat doctor. OHSS risk may be reduced by continuous monitoring of patients undergoing ovulation induction, using an appropriate gonadotropin dosage, and using additional agents known to decrease its risk. If OHSS still occurs, symptomatic treatment and a multidisciplinary team of professionals may be needed to prevent fluid build-up complications. In contrast to many published articles about OHSS and its complications, this is the first case report of a patient presenting serous otitis media as a complication of severe OHSS.
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Affiliation(s)
| | - Devin Lonergan
- San Ramon Regional Medical Center, San Ramon, California, USA
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Zang L, Lv H, Du J, Pan Y, Lin Y, Dai J. Association of phthalate exposure with low birth weight in couples conceiving naturally or via assisted reproductive technology in a prospective birth cohort. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 855:158852. [PMID: 36122707 DOI: 10.1016/j.scitotenv.2022.158852] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/14/2022] [Accepted: 09/14/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Few studies have investigated the adverse effects of preconception phthalate (PAE) exposure on birth weight in couples receiving assisted reproductive technology (ART) compared to naturally conceived newborns. OBJECTIVES We examined the association between parental preconception/prenatal urinary phthalate exposure and low birth weight (LBW) risk in couples who conceived using ART or naturally. METHODS From the Jiangsu Birth Cohort Study (China), we recruited 544 couples who conceived after infertility treatment and 940 couples who conceived naturally and gave birth to a singleton infant between November 2014 and December 2019. Seventeen metabolites of phthalate and three metabolites of phthalate alternatives were analyzed in parental spot urine samples. Clinical data were collected from medical records. We used generalized linear models, elastic net regression, Bayesian kernel machine regression, and quantile-based g-computation to examine the individual and joint effects of parental phthalate exposure on birth weight and LBW risk ratios (RR). RESULTS The relationship between parental phthalate exposure and birth weight was consistent between ART and natural conception. Maternal exposure to mono-ethyl phthalate and mono-carboxyisooctyl phthalate was associated with an increased risk of LBW in ART-conceived infants (RR = 1.27; 95 % confidence interval (CI): 1.03, 1.56; and RR = 1.31; 95 % CI: 1.03, 1.67, respectively). In contrast, in the spontaneously conceived infants, higher paternal prenatal concentrations of mono-benzyl phthalate and mono-carboxyisononyl phthalate were associated with a 40 % and 53 % increase in LBW risk, respectively. Exposure to PAE mixtures was associated with LBW in ART-conceived infants, with the effects primarily driven by di-ethyl phthalate, benzylbutyl phthalate, and di-isononyl phthalate metabolites. Sex-specific LBW was observed, with females appearing to be more susceptible than males. CONCLUSIONS Maternal preconception and paternal prenatal exposure to phthalates were associated with increased risk of LBW in infants. Compared with natural conception, ART-conceived fetuses were more sensitive to PAE mixtures, which requires further attention.
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Affiliation(s)
- Lu Zang
- State Environmental Protection Key Laboratory of Environmental Health Impact Assessment of Emerging Contaminants, School of Environmental Science and Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China; Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
| | - Hong Lv
- State Keey Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou 215006, China
| | - Jiangbo Du
- State Keey Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Yitao Pan
- State Environmental Protection Key Laboratory of Environmental Health Impact Assessment of Emerging Contaminants, School of Environmental Science and Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China; State Keey Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Yuan Lin
- State Keey Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; State Key Laboratory of Reproductive Medicine (Suzhou Centre), Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou 215006, China.
| | - Jiayin Dai
- State Environmental Protection Key Laboratory of Environmental Health Impact Assessment of Emerging Contaminants, School of Environmental Science and Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China; State Keey Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
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