Mandelbaum R, et al. - Researchers extracted hospital discharge records of women <50 years of age with ovarian hyperstimulation syndrome (OHSS) and no other ovarian pathology via retrospective analysis of the Nationwide Inpatient Sample between 2001-2015 in order to determine the incidence of OHSS-related ovarian torsion and severe medical complications. Further, they sought to assess the characteristics of and interventions required for women with OHSS and ovarian torsion. During the study period, they identified 14,623 women who were admitted with OHSS; ovarian torsion was reported in 313 (2.1%) of these. This suggests ovarian torsion occurrence in one in fifty of the patients and over 10% of these underwent oophorectomy for ovarian torsion, a devastating outcome for fertility-seeking patients. Pregnant patients more frequently suffered torsion but with fewer medical complications, supporting the hypothesis that torsion in OHSS results from increased ovarian volumes rather than increased capillary permeability. Based on hospital teaching status and geographic region, rates of torsion and oophorectomy differed, respectively. They recommend increasing awareness regarding the risk of torsion and prompt medical evaluation provided if torsion is suspected, in view of increasing outpatient management of non-severe OHSS.