A young woman who is receiving fertility treatment presents complaining of feeling bloated with a tense abdomen.
There is a large amount of free fluid. The uterus is normal. Both ovaries are greatly enlarged. Colour Doppler flow is seen within both ovaries (although note that the presence of colour flow does not exclude torsion of the ovary).
Ovarian hyperstimulation, in its more severe form causes capillary leak resulting in ascites and pleural effusions (this patient did not have pleural effusions). Torsion is a potential complication, although the absence of severe, unilateral pain made this unlikely.