title: Severe ovarian hyperstimulation syndrome after gonadotropin-releasing hormone (GnRH) agonist trigger and "freeze-all" approach in GnRH antagonist protocol.
abstract: OBJECTIVE
  To report two cases with GnRH agonist triggering and a freeze-all approach in a GnRH antagonist protocol resulting in the development of severe ovarian hyperstimulation syndrome (OHSS), requiring hospitalization and peritoneal drainage.
  
  
  METHODS
  Two case reports.
  
  
  METHODS
  A tertiary referral center and an obstetrics and gynecology department of a hospital.
  
  
  METHODS
  Case 1 and case 2: severe OHSS with abdominal distension, ascites development, and hemoconcentration.
  
  
  METHODS
  Case 1 and case 2: diagnosed by clinical, hematologic, and ultrasound findings. Hospitalization, IV infusion, and peritoneal drainage.
  
  
  METHODS
  Symptomatic treatment and prevention of further complication.
  
  
  RESULTS
  Complete recovery.
  
  
  CONCLUSIONS
  Two cases of severe OHSS after GnRH agonist trigger in a GnRH antagonist protocol without the administration of any hCG for luteal-phase support. Clinicians have to be aware that even the sequential approach to ovarian stimulation with a freeze-all attitude does not completely eliminate OHSS in all patients.
authors.affiliation: Center for Reproductive Medicine, Dutch-Speaking Free University Brussels, Brussels, Belgium. Electronic address: Human.MousaviFatemi@uzbrussel.be.
authors.forename: Human Mousavi
authors.initials: HM
authors.lastname: Fatemi
authors.affiliation: Special Gynecology Hospital "Ivanovic", Belgrade, Serbia.
authors.forename: Biljana
authors.initials: B
authors.lastname: Popovic-Todorovic
authors.affiliation: Fertility Clinic, Skive Regional Hospital and Faculty of Health, Aarhus University, Aarhus, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Humaidan
authors.affiliation: Department of Obstetrics and Gynecology, IVF Unit, Rambam Medical Center, Haifa, Israel.
authors.forename: Shahar
authors.initials: S
authors.lastname: Kol
authors.affiliation: NOVAIVI, Ahmadabad, India.
authors.forename: Manish
authors.initials: M
authors.lastname: Banker
authors.affiliation: Center for Reproductive Medicine, Dutch-Speaking Free University Brussels, Brussels, Belgium.
authors.forename: Paul
authors.initials: P
authors.lastname: Devroey
authors.affiliation: Instituto Valenciano de Infertilidad-MADRID, Madrid, Spain.
authors.forename: Juan Antonio
authors.initials: JA
authors.lastname: García-Velasco
mesh_terms: D000328:Adult; D005260:Female; D005640:Follicle Stimulating Hormone / Q000009:adverse effects*; D007987:Gonadotropin-Releasing Hormone / Q000037:antagonists & inhibitors*; D006801:Humans; D016471:Ovarian Hyperstimulation Syndrome / Q000139:chemically induced* / Q000175:diagnosis / Q000517:prevention & control*; D010062:Ovulation Induction / Q000009:adverse effects* / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D007987:Gonadotropin-Releasing Hormone; D005640:Follicle Stimulating Hormone
keywords: GnRH agonist triggering; GnRH antagonist; freeze-all; ovarian hyperstimulation syndrome