Ovarian hyperstimulation syndrome: strategies for prevention.
Ovarian hyperstimulation syndrome (OHSS) is a serious, iatrogenic complication of ovarian stimulation. The following report is a review of traditional and new strategies to prevent the development of OHSS. Techniques such as reducing the ovarian stimulus, coasting and cryopreservation are discussed. Other more investigative strategies are also summarized, including follicular aspiration, in-vitro maturation of immature oocytes, the use of gonadotrophin-releasing hormone (GnRH) agonists to trigger ovulation and the use of volume expanders such as hydroxyethyl starch. In addition, a review of the internal experience with OHSS at the authors' institution is described. All these preventative approaches are based on current understanding of the physiologic mechanisms involved in the pathogenesis of OHSS.
Chen
Dehan
D
The Center for Reproductive Medicine and Infertility, Weill Cornell Medical College, 505 East 70th Street, HMT-340, New York, NY 10021, USA.
Burmeister
Lynn
L
Goldschlag
Dan
D
Rosenwaks
Zev
Z
D000418:Albumins / Q000378:metabolism*; D015925:Cryopreservation; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage / Q000037:antagonists & inhibitors / Q000378:metabolism; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000378:metabolism*; D007986:Luteinizing Hormone / Q000378:metabolism; D016471:Ovarian Hyperstimulation Syndrome / Q000517:prevention & control*; D010062:Ovulation Induction / Q000009:adverse effects*; D011994:Recombinant Proteins / Q000378:metabolism; D012307:Risk Factors; D013997:Time Factors
D000418:Albumins; D006895:Hydroxyethyl Starch Derivatives; D011994:Recombinant Proteins; D007987:Gonadotropin-Releasing Hormone; D007986:Luteinizing Hormone