Ovarian hyperstimulation syndrome management strategies: where are we going?

Ovarian hyperstimulation syndrome (OHSS) is one of the most frequent, serious and potentially lethal iatrogenic complications of controlled ovarian stimulation. Despite extensive research, the exact pathogenesis of this syndrome remains less clear, but there appears to be a relationship of increased vascular permeability mediated by HCG and other downstream mediators. Adequate experience with ovulation induction therapy and identifying patients with known risk factors are essential in preventing OHSS. As this is a completely iatrogenic disease numerous strategies have been investigated to help decrease the risk of OHSS and their effects on pregnancy and live birth rate. What follows is a review of the common strategies apply today to minimize risk of OHSS in patients undergoing assisted reproductive technologies.