Increased angiotensin-converting enzyme activity in a patient with severe ovarian hyperstimulation syndrome

Objective: To assess plasma angiotensin-converting enzyme (ACE) activity in a patient with severe ovarian hyperstimulation syndrome (OHSS). Design: Case report. Setting: Private, university-affiliated infertility practice. Patient(s): A 35-year-old woman with OHSS. Intervention(s): Clomiphene citrate induction of ovulation. Main Outcome Measure(s): Plasma ACE activity. Result(s): The patient had a brain stem infarction as a result of thrombosis caused by severe OHSS. Plasma ACE activity was significantly elevated and persisted long after resolution of the OHSS. Conclusion(s): Elevated ACE activity appears to have been associated with the development of OHSS in this patient. Further study of the ovarian renin-angiotensin system in the development of OHSS is warranted.