Ovarian Hyperstimulation Syndrome Caused by an FSH-Secreting Pituitary Adenoma

Odelia Cooper; Jordan L Geller; Shlomo Melmed


Nat Clin Pract Endocrinol Metab. 2008;4(4):234-238. 

In This Article


We present a case of a woman who developed OHSS due to an FSH-secreting pituitary adenoma. This syndrome comprises enlarged, multicystic ovaries, oligomenorrhea or amenorrhea, elevated estradiol levels and, usually, elevated serum FSH levels. After resection of the pituitary adenoma, the endocrine profile and symptoms revert to normal.

Our case brings to light two instructive points. Firstly, contrary to the assumption that gonadotrope adenomas are clinically nonfunctioning adenomas, FSH-secreting adenomas may in fact be functional, leading to hypersecretory symptoms as in the development of OHSS. Secondly, when clinicians encounter patients presenting with symptoms of abdominal pain, abnormal menses and multicystic ovaries, they should measure estradiol and gonadotropin levels to exclude OHSS caused by a pituitary adenoma. In our case, the patient had a 15-year history of such symptoms but had not undergone an endocrine work-up, which could have revealed the presence of a pituitary adenoma during that period. Clinical awareness and an appropriate endocrine work-up facilitate early diagnosis and treatment of this syndrome, thereby avoiding multiple therapeutic procedures for ovarian cysts and ultimately also restoring fertility.

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