Ovarian Hyperstimulation: Diagnosis, Prevention, and Management

Area of Science:

• Reproductive Endocrinology
• Clinical Obstetrics and Gynecology

Background:

• Ovarian hyperstimulation syndrome (OHSS) is a serious complication of controlled ovarian stimulation (COS).
• Its pathogenesis involves fluid transudation into body cavities, leading to variable clinical presentations based on severity.

Purpose of the Study:

• To review the prevention strategies and management of OHSS.
• To highlight the risks and management of associated complications, particularly venous thromboembolism (VTE).

Main Methods:

• Review of current literature on OHSS prevention and management.
• Discussion of diagnostic criteria and treatment approaches for different OHSS severities.
• Analysis of OHSS-related complications, including VTE.

Main Results:

• OHSS can be effectively prevented through patient selection, optimized COS protocols, GnRH agonist triggers, or freeze-all strategies.
• Most OHSS cases are managed outpatient; severe cases necessitate hospitalization for rehydration and monitoring.
• Venous thromboembolism is a significant risk, with thromboprophylaxis being standard, though low-dose aspirin (LDA) use remains debated.

Conclusions:

• Modern strategies allow for effective prevention and management of OHSS.
• Vigilance for severe complications like VTE is crucial, necessitating appropriate thromboprophylaxis.