OVARIAN HYPERSTIMULATION SYNDROME

Abstract

The ovarian hyperstimulation syndrome (OHSS) is an iatrogenic condition with a varied spectrum of clinical and laboratory manifestations. It is an important side effect of treatment with fertility drugs e.g. human menopausal gonadotrophins (hMG), follicle stimulating hormone (FSH), gonadotrophin hormone releasing hormone (GnRH), human chorionic gonadotrophin (hCG) and less commonly clomphene citrate and other antioestrogens. Recognizing the OHSS high-risk profile is probably the most important

measure of prevention the physician can take before beginning any COH cycle or ovulation induction. Of the variables reviewed in the Risk Factors section, young age and evidence of PCOS are perhaps the most valuable, as these factors can be assessed before administering medications. Once a high-risk clinical profile is established, the next step should be to individualize the patient's medication regimen by many factors. With early recognition of OHSS and prompt, aggressive, and vigilant attention to fluid management, thrombosis prevention, and treatment of ascites, most cases should not result in critical sequelae. OHSS can, however, be unpredictable in severity and course. Renal failure, hepatic damage, thromboembolic phenomena, and ARDS are known to occur despite attentive case.