Management of Bilateral Adnexal Torsion in a Case of Ovarian Hyperstimulation Syndrome

Abstract

Adnexal torsion (AT) is usually unilateral and traditionally treated by oophorectomy. We present acase of bilateral AT, developed consequent to ovarian hyperstimulation syndrome (OHSS), managed by detorsion of the ovaries without oophorectomy. A 27-year-old female patient who underwent in vitro fertilization was hospitalized with acute abdomen. On ultrasonography, multifollicularovaries, displaying continuity with each other on both sides with a size of 25×12 cm, which areconsistent with OHSS and no apparent blood flw in the right adnexal area, were observed. Inlaparotomy, the right ovary (10×8 cm), left ovary (16×14 cm), and adnexa were bilaterally torsioned.Adnexa was detorsioned. Although it is assumed that blood flw did not improve in the ovaries,considering the patient’s fertility desire, oophorectomy was not performed. On sonography at 6months, the size of the ovaries and blood flw were normal. Conservative surgery should be thefist choice of treatment in AT to preserve fertility in patients who underwent artifiial reproductivetechnologies.