Ovarian hyperstimulation syndrome

Abstract

In the article all the basic characteristics, clinical significance, risk factors, pathogenesis, prevention and treatment modalities of ovarian hyperstimulation syndrome were described. In the introduction all the main characteristics, classifications and incidence of the syndrome were noted. The best known risk and predictive factors that characterize the patients at risk with their significance include polycystic ovarian disease, multiple and immature follicles, young age (<35 years), lean habitus, high serum estradiol (>3000 pg/ml), hypothyroidism, hyperprolactinemia, oligomenorrhea, anovulatory infertility, stimulation protocols with gonadotrophin releasing hormone agonists, and human chorionic gonadotrophin for the induction of ovulation and luteal support were reported. To understand modern etiologic aspects and pathophysiologic mechanisms in the development of the syndrome the underlying causes of all relevant vasoactive substances were described. In the prophylaxis of the syndrome all significant and judicious methods and procedures which could prevent the appearance of symptoms were reported. Modern strategies for the treatment of OHSS which include macromolecular plasma expanders with its usefulness and controversies, diuretics, paracentesis, anticoagulants and surgery, that could reduce the complications and long-term sequels were described.