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Ovarian hyperstimulation syndrome.

B McElhinney¹, N McClure

¹Department of Obstetrics and Gynaecology, Institute of Clinical Science, Belfast, UK.

Bailliere'S Best Practice & Research. Clinical Obstetrics & Gynaecology

|May 2, 2000

Summary

Ovarian hyperstimulation syndrome (OHSS) is a severe complication of assisted reproduction. While its exact cause is unknown, inflammatory cytokines and growth factors play a role, necessitating careful patient monitoring and supportive care.

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Area of Science:

Reproductive Medicine
Endocrinology
Critical Care Medicine

Background:

Ovarian hyperstimulation syndrome (OHSS) is a serious, potentially fatal iatrogenic complication of assisted reproduction.
Key features include ovarian enlargement, capillary leak leading to fluid accumulation (ascites, hydrothorax), and potential organ dysfunction.

Purpose of the Study:

To review the clinical components, pathophysiology, risk prediction, and management of ovarian hyperstimulation syndrome.
To highlight the role of inflammatory mediators and the limitations of current treatment strategies.

Main Methods:

Review of existing literature on ovarian hyperstimulation syndrome.
Analysis of clinical manifestations, proposed pathophysiological mechanisms, and treatment approaches.

Main Results:

Severe OHSS presents with significant fluid shifts, thromboembolic events, respiratory distress, and renal failure.
Evidence suggests inflammatory cytokines and angiogenic growth factors are central to OHSS pathophysiology.
Ultrasound and estradiol levels aid in risk prediction, but prevention remains challenging.

Conclusions:

Management focuses on supportive care, fluid balance, and renal perfusion until spontaneous resolution.
Preventive strategies have limited success; further research into anticytokine agents may offer therapeutic potential.

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