The case of a young egg donor who, at only 23 years old, died on the operating table during a routine procedure o retrieve oocytes for donation, has recently been published.
The deceased was subjected to various tests before carrying out the procedures relevant to the oocyte donation. It was found that she had no risk factors, no previous history of abortion, diabetes, hypertension, asthma, allergies, alcohol or tobacco, nor did she have abnormal heart or respiratory sounds. Therefore, the patient was a healthy young woman.
After performing the autopsy, death was attributed to respiratory failure caused by massive acute pulmonary edema, as a consequence of a complication of Ovarian Hyperstimulation Syndrome (OHSS).
Ovarian Hyperstimulation Syndrome (OHSS) is a complication that can be triggered during controlled ovarian stimulation (COS). This is due to an exaggerated response to ovulation induction, causing the secretion of ovarian vasoactive-angiogenic substances such as estrogen, gonadotropin or prostaglandin. These vasoactive substances increase capillary permeability causing the accumulation of fluid in the extravascular space.
According to the World Health Organization (WHO), the incidence of moderate or severe ovarian hyperstimulation syndrome (OHSS) is low, between 0.2-1% of all stimulation cycles in assisted reproduction.
In moderate or severe cases, the associated symptoms are extreme thirst, signs of dehydration such as dark urine and difficulty breathing if there is fluid in the lungs, or clots in the legs or lungs.
However, the presence of mild ovarian hyperstimulation syndrome (OHSS) after an oocyte donation is relatively common, with an incidence of 33% according to the Royal College of Obstetricians and Gynecologists (RCOG). The symptoms themselves are abdominal swelling, discomfort and nausea. The symptoms usually resolve without the need for treatment in the following 7 or 10 days.
An increasingly widespread technique
Egg donation is becoming more frequent due to the increased demand for in vitro fertilization (IVF). However, assisted reproductive techniques (ART) can trigger numerous complications during or after oocyte retrieval.
Some of them, according to an article published in the National Library of Medicine, are Ovarian Hyperstimulation Syndrome (OHSS), ovarian torsion, infection, ovarian cyst ruptured, adverse reaction to intravenous anesthesia, intrabdominal bleeding after aspiration, bladder atony, and hematuria.
Given the incidence of this complication in the frequent processes of oocyte retrieval linked to ART, women who access these techniques must be fully informed of this risk, especially when they are requested not to solve a problem of sterility but exclusively to donate oocytes or cryopreserve them when fertile women decide to postpone motherhood by resorting to ART.