Pharmacotherapy of ovarian hyperstimulation syndrome.
BACKGROUND
One of the main objectives in assisted reproduction techiques (ART) is the maturation of multiple follicles and the recovery of multiple good quality oocytes. To realize this, it is necessary to interfere with the mechanisms of selection and follicular dominance, characteristic of spontaneous mono-ovulatory cycles, by administering gonadotrophins. In 12 - 20% of the stimulation cycles, the response to ovarian stimulation in terms of follicular development is higher than expected, with the onset of the so-called ovarian hyperstimulation syndrome (OHSS). This is considered to be an exaggerated response: an iatrogenic - possibly life-threatening - complication of ovarian stimulation.


METHODS
This review deals about reproductive, obstetric and gynecological aspects of OHSS.


RESULTS
Understanding the pathophysiology of OHSS is the key to establishing a correct pharmacotherapy. However, the mechanisms underlying OHSS have not yet been completely clarified. Treatment of OHSS is empirical, so prevention is the most important aspect in its management. Several studies support the role of vascular endothelial growth factor in the development of OHSS in humans, so future studies about anti-angiogenetic molecules seem to be an important goal in ART.


CONCLUSIONS
Methods to prevent OHSS.
Genazzani
Andrea Riccardo
AR
University of Pisa, Department of Reproductive Medicine and Child Development, Italy.
Monteleone
Patrizia
P
Papini
Francesca
F
Artini
Paolo Giovanni
PG
D000082:Acetaminophen / Q000627:therapeutic use; D000818:Animals; D005260:Female; D006727:Hormone Antagonists / Q000627:therapeutic use; D006801:Humans; D008687:Metformin / Q000627:therapeutic use; D016471:Ovarian Hyperstimulation Syndrome / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects
D006727:Hormone Antagonists; D000082:Acetaminophen; D008687:Metformin