Patients with a history of hyperemesis gravidarum have similar symptoms during egg stimulation and develop ovarian hyperstimulation syndrome: case series

• Published in: Fertility and sterility Vol. 93; no. 1; pp. 267.e9 - 267.e11
• Main Authors: Fejzo, Marlena S., Ph.D, Romero, Roberto, M.D, Goodwin, T. Murphy, M.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2010
• Subjects: Adult; Female; fertility; Fertilization in Vitro; Genetic Predisposition to Disease; Humans; Hyperemesis gravidarum; Hyperemesis Gravidarum - genetics; Hyperemesis Gravidarum - physiopathology; Hyperemesis Gravidarum - therapy; Internal Medicine; Nausea - etiology; Obstetrics and Gynecology; ovarian hyperstimulation syndrome; Ovarian Hyperstimulation Syndrome - etiology; Ovarian Hyperstimulation Syndrome - physiopathology; Ovulation Induction - adverse effects; Parenteral Nutrition, Total; Pregnancy; Severity of Illness Index; surrogacy; Surrogate Mothers; Vomiting - etiology; ovarian hyperstimulation syndrome; Hyperemesis gravidarum; fertility; surrogacy
• ISSN: 0015-0282; 1556-5653
• DOI: 10.1016/j.fertnstert.2009.09.022

Objective To investigate the symptoms and outcomes of ovarian stimulation in patients with a history of hyperemesis gravidarum. Design Retrospective case series. Setting Research laboratory of a university hospital. Patient(s) Participants in an ongoing study on hyperemesis gravidarum that reported ovarian stimulation for gestational surrogacy. Intervention(s) Review of medical records. Main Outcome Measure(s) Pregnancy history, symptoms, estradiol level and mature oocyte number in cases, and nausea and vomiting level reported in surrogate. Result(s) Three cases in their early thirties with a history of hyperemesis gravidarum presented with severe nausea and vomiting during ovarian stimulation and ovarian hyperstimulation syndrome. Gestational carriers reported normal nausea and vomiting of pregnancy. Conclusion(s) This series provides lessons for in vitro fertilization for cases with a history of hyperemesis gravidarum and their gestational carriers as well as insight into the cause of hyperemesis gravidarum and its potential role in fertility. A link between hyperemesis gravidarum and an evolutionary advantage of increased fertility suggests a novel theory to explain the selection for nausea and vomiting in pregnancy.