Revisiting ovarian hyper stimulation syndrome: Towards OHSS free clinic
- PMID: 25838743
- PMCID: PMC4381376
- DOI: 10.4103/0974-1208.153120
Revisiting ovarian hyper stimulation syndrome: Towards OHSS free clinic
Abstract
A rapid development and application of assisted reproductive technologies (ARTs) and ovulation-induction drugs may lead to ovarian hyper stimulation syndrome (OHSS). Young age, low body mass index (BMI), polycystic ovarian syndrome (PCOS), previous OHSS, high follicle count, and elevated serum estradiol (E2) are the certain factors that predispose women to OHSS. Many strategies have been used to reduce or avoid OHSS. Use of human chorionic gonadotropin (hCG) increases ovarian vascular permeability and is responsible for activating the vascular endothelial growth factors (VEGF) pathway and thus the entire cascade, leading to symptomatic OHSS. Gonadotropin-releasing hormone (GnRH) agonists are used as a replacement for hCG for final oocyte maturation in antagonist cycles. Reducing or eliminating the use of hCG and use of GnRH agonist triggered GnRH antagonist cycles and cryopreservation of oocytes or embryos is the most promising approach in making OHSS free clinic a reality.
Keywords: Agonist; GnRH; and hCG; antagonist; assisted reproductive technology.
Conflict of interest statement
References
-
- Delvigne A, Rozenberg S. Epidemiology and prevention of ovarian hyperstimulation syndrome (OHSS): A review. Hum Reprod Update. 2002;8:559–77. - PubMed
-
- Lyons CA, Wheeler CA, Frishman GN, Hackett RJ, Seifer DB, Haning RV., Jr Early and late presentation of the ovarian hyperstimulation syndrome: Two distinct entities with different risk factors. Hum Reprod. 1994;9:792–9. - PubMed
-
- Bulun SE, EY . The physiology and pathology of the female reproductive axis. In: Kronenberg H.K., editor. Williams textbook of endocrinology. 11th ed. Philadelphia: Saunders; 2008.
-
- Navot D, Bergh PA, Laufer N. Ovarian hyperstimulation syndrome in novel reproductive technologies: Prevention and treatment. Fertil Steril. 1992;58:249–61. - PubMed
-
- Delvigne A, Demoulin A, Smitz J, Donnez J, Koninckx P, Dhont M, et al. The ovarian hyperstimulation syndrome in in-vitro fertilization: A Belgian multicentric study. I. Clinical and biological features. Hum Reprod. 1993;8:1353–60. - PubMed
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