Severe ovarian hyperstimulation syndrome requiring recurrent large-volume paracenteses until 21 weeks' gestation: a case report.

Objective: To report a case of severe ovarian hyperstimulation syndrome (OHSS) persisting into the late second trimester of a singleton pregnancy. Design: Case report. Setting: Academic tertiary care center. Patients: A 29-year-old woman with severe OHSS after fresh embryo transfer after controlled ovarian hyperstimulation requiring intervention until 21 weeks' gestation in a singleton pregnancy. Interventions: Thorough evaluation of an unusual case of severe OHSS and medical/procedural management of its sequelae in the setting of ongoing pregnancy. Main Outcome Measuress: The clinical development of severe OHSS during pregnancy and its effect on pregnancy outcomes. Results: Severe OHSS persisted until 21 weeks' gestation with reaccumulating ascitic fluid, which impacted pregnancy outcomes. Conclusions: Clinicians should be aware of the risk of severe OHSS and its possible effect on pregnancy outcomes beyond the first trimester.

The Impact of Uterine Fibroids on Fertility: How the Uncertainty Widens the Gap in Reproductive Outcomes in Black Women.

Uterine fibroids (UFs) are the most common pelvic tumor in women. While the decreased quality of life and significant morbidity has been implicated with UFs, several important questions regarding the effect of UFs on reproductive outcomes remain unanswered. Furthermore, there is a disproportionate impact of UFs in Black women, in whom these tumors are known to be more common and more severe. The racial difference in UF burden is heightened during prime reproductive years, during which Black women undergo surgical intervention at an astoundingly increased rate compared to other races. Despite this, Black women are underrepresented in UF and treatment outcome research, and thus the uncertainty of the impact of UFs and UF treatment on fertility and pregnancy outcomes in this population is less defined. The purpose of this review article is to discuss recent findings in the literature regarding the impact of uterine UFs on reproductive outcomes with a primary focus on the implications for Black women. Additionally, we briefly discuss the importance of increased UF research funding and investigation and propose actionable items to help increase the representation of Black women in UF research.