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Accidental hyperstimulation during ovulation induction.

J Salat-Baroux, J M Antoine

    Bailliere'S Clinical Obstetrics and Gynaecology
    |September 1, 1990
    PubMed
    Summary
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    Ovarian hyperstimulation syndrome is a serious complication of ovulation induction, affecting about 3% of patients. Prevention and early recognition in high-risk individuals are key to managing this iatrogenic disorder.

    Area of Science:

    • Reproductive Endocrinology
    • Obstetrics and Gynecology
    • Infertility Treatment

    Background:

    • Ovarian hyperstimulation syndrome (OHSS) is the most severe complication of ovulation induction therapies.
    • It occurs in approximately 3% of cases, with severe forms seen in 0.8%.
    • Risk factors include polycystic ovarian disease, hyperprolactinemia, and hypothyroidism.

    Purpose of the Study:

    • To review the current knowledge on ovarian hyperstimulation syndrome (OHSS).
    • To discuss its frequency, associated factors, clinical presentation, pathophysiology, treatment, and prevention.
    • To highlight OHSS as a significant iatrogenic complication of ovulation induction.

    Main Methods:

    • Review of existing literature on ovarian hyperstimulation syndrome.

    Related Experiment Videos

  • Analysis of clinical stages (mild, moderate, severe) described by the WHO.
  • Discussion of potential pathophysiological mechanisms including prostaglandins and the ovarian renin-angiotensin system.

    • Main Results:

    • Luteinizing hormone-releasing hormone (LHRH) agonists have not reduced OHSS incidence and may increase it.
    • Ongoing pregnancy predisposes to OHSS due to human chorionic gonadotropin (hCG) secretion.
    • In vitro fertilization (IVF) appears to have a lower incidence, possibly due to follicle aspiration.

    Conclusions:

    • Prevention is crucial, involving recognition of high-risk patients and appropriate stimulation protocols.
    • Management of severe OHSS includes symptomatic treatment and specific interventions like corticosteroids or pregnancy termination.
    • Monitoring ovulation induction with daily ultrasound and hormonal assays is essential for preventing excessive responses.