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Related Experiment Video

Updated: May 20, 2026

Fertility Preservation Through Oocyte Vitrification: Clinical and Laboratory Perspectives
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Fertility Preservation Through Oocyte Vitrification: Clinical and Laboratory Perspectives

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Outpatient paracentesis for Ovarian Hyperstimulation Syndrome: STOP-OHSS feasibility study and RCT Synopsis.

Mostafa Metwally1, Katie Ridsdale1, Clare Pye2

  • 1Sheffield Centre for Health and Related Research, The University of Sheffield, Sheffield, UK.

Health Technology Assessment (Winchester, England)
|May 19, 2026
PubMed

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Atypical presentation of severe ovarian hyperstimulation syndrome complicated by isolated pleural effusions: a case series and literature review.

Human fertility (Cambridge, England)·2026
Summary

Early outpatient paracentesis for ovarian hyperstimulation syndrome (OHSS) could not be evaluated due to poor recruitment, exacerbated by the COVID-19 pandemic. Changes in fertility clinic practices have reduced OHSS incidence, impacting trial feasibility.

Area of Science:

  • Reproductive endocrinology and infertility treatments.
  • Clinical trial methodology and adaptive trial designs.
  • Health services research and economic evaluations.

Background:

  • Ovarian hyperstimulation syndrome (OHSS) is a serious risk of fertility treatments, often managed with hospitalization for severe cases.
  • Early outpatient paracentesis is a potential intervention to prevent hospitalization for OHSS.
  • Randomized trials are needed to establish the effectiveness of early outpatient paracentesis for OHSS.

Purpose of the Study:

  • To assess the clinical and cost-effectiveness of early outpatient management for moderate to severe OHSS.
  • To evaluate the safety and acceptability of early active outpatient management for OHSS.
  • To compare outpatient paracentesis with usual conservative care for OHSS.

Main Methods:

Keywords:
ASSISTEDCLINICAL PROTOCOLSCONSERVATIVE TREATMENTCOVID-19DELIVERY OF HEALTH CAREDISEASE PROGRESSIONFERTILITYFERTILITY CLINICSGONADOTROPIN-RELEASING HORMONEHOSPITALISATIONOUTPATIENTSOVARIAN HYPERSTIMULATION SYNDROMEPARACENTESISRANDOMISED CONTROLLED TRIALS AS TOPICREPRODUCTIVE TECHNIQUES

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  • A pragmatic, multicenter, superiority, adaptive randomized controlled trial was planned.
  • Participants with moderate or severe OHSS were randomized 1:1 to outpatient paracentesis or usual care.
  • The primary outcome was OHSS-related hospital admission within 28 days.

Main Results:

  • The trial terminated early due to poor recruitment (8 participants randomized vs. 224 planned).
  • Two participants required hospitalization for OHSS-related reasons (one from each group).
  • Post-trial survey indicated increased use of OHSS preventive measures post-COVID-19 pandemic.

Conclusions:

  • The study could not determine the effectiveness, safety, or cost-effectiveness of outpatient management for OHSS due to small sample size.
  • The COVID-19 pandemic significantly impacted recruitment and clinical practices, reducing OHSS incidence.
  • Future research may require alternative designs, such as observational studies, to reflect current clinical realities.