24yrs old female, married since 2yrs came for infertility treatment, ovulation induction was done with CC 50mg for 5 days and inj.HCG 5000IU was given on 11th day, after 7 days of HCG, pt came with C/O lower abdominal pain on left side. on examination, tenderness over left iliac fossa made out. USG Shows 2 follicles seen on right side  measures 4.5×3.7 cm & 4.5×4.7cm. what is the cause & management?

It is ovarian hyperstimulation syndrome. Give fluids and symptomatic management. Give ocp for 3 cycles for resolution of cyst. Do usg after 3 cycles ,if cyst reduced then start next cycle of OI with letrozole 2.5mg from day 2 to6 . Give HCG if only single follicle test developed and more than 20 mm. If multiple follicles developed give tab.cabgoline 0.5 mg for 8 days to prevent OHSS . And give luprolide inj for ovulation. Don't use cc in next cycle ofOI.
K. Thank u

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