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

Abstract

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.