Ovarian hyperstimulation syndrome: pathophysiology and prevention.

Abstract:

PURPOSE:To review and discuss the pathophysiology and prevention strategies for ovarian hyperstimulation syndrome (OHSS), which is a condition that may occur in up to 20% of the high risk women submitted to assisted reproductive technology cycles. METHODS:The English language literature on these topics were reviewed through PubMed and discussed with emphasis on recent data. RESULTS:The role of estradiol, luteinizing hormone, human chorionic gonadotropin (hCG), inflammatory mediators, the renin-angiotensin system and vascular endothelial growth factor is discussed in the pathophysiology of OHSS. In addition we consider the prevention strategies, including coasting, administration of albumin, renin-angiotensin system blockage, dopamine agonist administration, non-steroidal anti-inflammatory administration, GnRH antagonist protocols, reducing hCG dosage, replacement of hCG and in vitro maturation of oocytes (IVM). CONCLUSIONS:Among the many prevention strategies that have been discussed, the current evidence points to the replacement of hCG by GnRH agonists in antagonist cycles and the performance of IVM procedures as the safest approaches.

journal_name

J Assist Reprod Genet

authors

Nastri CO,Ferriani RA,Rocha IA,Martins WP

doi

10.1007/s10815-010-9387-6

subject

Has Abstract

pub_date

2010-02-01 00:00:00

pages

121-8

issue

2-3

eissn

1058-0468

issn

1573-7330

journal_volume

27

pub_type

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