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Agrawal, et al.: Rare case of spontaneous ohss in a spontaneous conception14 MOGS Chronicles | Volume 1 | Issue 1 | September 2024OHSS usually occurs at 8%u201314 weeks gestation in contrast to OHSS which occurs at 3%u20135 weeks of gestation.[3]Potential risk factors include young age, low body mass index, history of polycystic ovaries, multiple gestation, and hypothyroidism.[1] Due to plethora of potentially life threatening complications, early diagnosis and treatment becomes quintessential. This is possible in cases of OHSS related to its use in treatment of infertility since it can be predicted and managed in time. However, in sOHSS, it is fairly difficult since diagnosis can be done once they are symptomatic. Management of sOHSS is dependent on the stage where early stages can be managed on out patient department basis. But, severe and critical cases, like in our case, hospital admission with adequate fluid replacement and thromboprophylaxis becomes necessary to avoid complications. A meta-analysis done by Tang et al. revealed use of cabergoline to be effective in cases of OHSS since it reduces vascular permeability by inhibiting vascular endothelial growth factor-2 receptor.[4]ConclusionEarly recognition and timely management of such cases ensures prevention of fatal complications yielding good outcome.DeclarationNote: Patient referred to this in case has consented for this publication.References1. Chai W, He H, Li F, Zhang W, He C. Spontaneous ovarian hyperstimulation syndrome in a nonpregnant female patient: a case report and literature review. J Int Med Res 2020;48:300060520952647.2. Liang X, Yu X, Guo X, Wang F. A case report of spontaneous ovarian hyperstimulation syndrome and the long-term management of the endocrine disorder. Ann Transl Med 2022;10:384.3. Pail S, Bagri N, Ghas R. Hypothyroidism induced spontaneous ovarian hyperstimulation syndrome: A rare yet interesting dilemma.New Indian J OBGYN 2023;10:229-32.4. Neha, Chauhan M, Chaudhary D. A rare case on ovarian hyperstimulation syndrome in a spontaneous singleton pregnancy.Int J Reprod Contracept Obstet Gynecol 2024;13:1881-4.%u00a9 The Author(s). 2024 Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons. org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/ zero/1.0/) applies to the data made available in this article, unless otherwise stated.Figure 2: Ultrasound image of Bulky ovary with intrauterine gestational sacFigure 1: Ultrasound image of bulky ovary showing fishnet appearanceEditor%u2019s NoteOHSS is more commonly linked to assisted reproductive technologies, spontaneous OHSS is a rare event reported in 0.2%u20131.2% cases occurring spontaneously in pregnancy without exogenous hCG use. It can present with abdominal pain, distention, and respiratory symptoms.Early diagnosis is important and crucial for management of the patient, to reduce the maternal mortality rates. The case illustrates the need for awareness among clinicians and the experience of the reporting authors may serve as a guide for similar cases in the future. Management strategies include effective use of supportive therapies, including fluid management and thromboprophylaxis, as well as the novel application of cabergoline in non pregnant patients. In severe cases hospitalization maybe required.How to cite this article: Agrawal A, Gupta P, Mehendale M, Sarmalkar M. A Rare Case of Spontaneous Ovarian Hyperstimulation Syndrome in a Spontaneous Conception with Conservative Management. MOGS Chronicles 2024;1(1):13-14.