title: Pharmacotherapy of ovarian hyperstimulation syndrome.
abstract: 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.
authors.affiliation: University of Pisa, Department of Reproductive Medicine and Child Development, Italy.
authors.forename: Andrea Riccardo
authors.initials: AR
authors.lastname: Genazzani
authors.forename: Patrizia
authors.initials: P
authors.lastname: Monteleone
authors.forename: Francesca
authors.initials: F
authors.lastname: Papini
authors.forename: Paolo Giovanni
authors.initials: PG
authors.lastname: Artini
mesh_terms: 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
chemical_list: D006727:Hormone Antagonists; D000082:Acetaminophen; D008687:Metformin