It is known that most cases of Ovarian Hyperstimulation Syndrome (OHSS) are associated with the therapies for ovulation induction. However, OHSS may rarely be associated with a spontaneous ovulatory cycle, usually in the case of multiple gestations, hypothyroidism or polycystic ovarian syndrome. We report a case of moderate OHSS in spontaneously conceived twin pregnancy in a 24 years old woman. The clinical picture showed amenorrhea,nausea, vomiting, abdominal pain and moderate ascites. After examinations, imaging and laboratory investigations, the diagnosis was established. The patient was managed expectantly with no complications. Although spontaneous ovarian hyperstimulation is a rare entity, it is important that the physician recognizes this condition. Prompt diagnosis and successful management is likely to avoid serious complications, which may develop rapidly.
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