title: An update on the prevention of ovarian hyperstimulation syndrome.
abstract: Ovarian hyperstimulation syndrome is a potentially life-threatening, but preventable iatrogenic complication of in vitro fertilisation treatment. In recent years, new strategies have been developed to minimise the risk of ovarian hyperstimulation syndrome after in vitro fertilisation, including better at-risk patient identification prior to starting treatment, the use of a lower human chorionic gonadotrophin dose or alternative medication instead of human chorionic gonadotrophin to induce final oocyte maturation such as gonadotrophin-releasing hormone agonist and kisspeptin in antagonist cycles, cryopreservation of all embryos and delayed embryo transfer, and the use of oral dopamine agonists after oocyte retrieval. In this article, the advantages and limitations of those new developments are discussed and future directions towards establishment of an ovarian hyperstimulation syndrome-free in vitro fertilisation clinic are explored.
authors.affiliation: Faculty of Medicine, Imperial College London, London, UK.
authors.forename: Omar
authors.initials: O
authors.lastname: El Tokhy
authors.affiliation: Assisted Conception Unit, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK.
authors.forename: Julia
authors.initials: J
authors.lastname: Kopeika
authors.affiliation: Assisted Conception Unit, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK tarek.el-toukhy@gstt.nhs.uk.
authors.forename: Tarek
authors.initials: T
authors.lastname: El-Toukhy
mesh_terms: D000077465:Cabergoline; D006063:Chorionic Gonadotropin / Q000008:administration & dosage; D018491:Dopamine Agonists / Q000627:therapeutic use*; D004873:Ergolines / Q000627:therapeutic use; D004958:Estradiol / Q000008:administration & dosage; D004967:Estrogens / Q000008:administration & dosage*; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D059648:Kisspeptins / Q000627:therapeutic use*; D016729:Leuprolide / Q000627:therapeutic use; D007986:Luteinizing Hormone / Q000627:therapeutic use*; D016471:Ovarian Hyperstimulation Syndrome / Q000517:prevention & control*; D010062:Ovulation Induction / Q000379:methods*; D011994:Recombinant Proteins; D012102:Reproductive Control Agents / Q000008:administration & dosage; D018570:Risk Assessment
chemical_list: D006063:Chorionic Gonadotropin; D018491:Dopamine Agonists; D004873:Ergolines; D004967:Estrogens; D005300:Fertility Agents, Female; C106628:KISS1 protein, human; D059648:Kisspeptins; D011994:Recombinant Proteins; D012102:Reproductive Control Agents; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D007986:Luteinizing Hormone; D016729:Leuprolide; D000077465:Cabergoline
keywords: dopamine agonists; gonadotrophin-releasing hormone agonist; in vitro fertilisation; intra-cytoplasmic sperm injection; kisspeptin; luteal phase; oocyte retrieval; ovarian hyperstimulation syndrome; prevention