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

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. Copyright 2010 American Society for Reproductive Medicine. All rights reserved.