Ovarian Hyperstimulation Syndrome, the Master of Disguise?

Figure 1

Schematic illustration of how OHSS causes a rise in d-dimers. Pg = prostaglandin; Plt = platelets; FDP = fibrin degradation productions; PT = prothrombin. (1) Dotted arrow represents normal blood flow. Prostaglandins are increased in OHSS which causes increased capillary permeability. This forces water out of the capillaries and into the tissues. (2) Loss of water causes hemoconcentration of the blood which is represented by thick arrows. Due to this, activation of platelets occurs. (3) Activation of platelets causes activation of the clotting cascade (simplified without the activated factors). (4) The final products of the coagulation cascade are fibrin degradation products which can be measured in the blood as d-dimers.