Skip to main content Accessibility help
×
Hostname: page-component-848d4c4894-mwx4w Total loading time: 0 Render date: 2024-06-22T02:44:46.844Z Has data issue: false hasContentIssue false

Chapter 16 - Treatment of Ovarian Hyperstimulation Syndrome

from Section 3 - Difficulties and Complications of Ovarian Stimulation and Implantation

Published online by Cambridge University Press:  14 April 2022

Mohamed Aboulghar
Affiliation:
University of Cairo IVF Centre
Botros Rizk
Affiliation:
University of South Alabama
Get access

Summary

Although, ovarian hyperstimulation syndrome (OHSS) is the most serious iatrogenic complication of ovarian stimulation, the condition usually resolves within 14 days in women who are subjected to freeze-all embryos policy; meanwhile symptoms may extend through the first trimester in women who do become pregnant as endogenous human chorionic gonadotropin (hCG) levels continue to stimulate the ovaries. The exact pathophysiology and etiology of OHSS remains unknown, but increased capillary permeability with the resulting loss of fluid into the third space is common to the syndrome [1]. Administration of hCG for final follicle maturation and triggering of ovulation appears to be the pivotal stimulus in a susceptible patient, by releasing vasoactive–angiogenic substances such as vascular endothelial growth factor from the ovaries hyperstimulated with gonadotropins [2].

Type
Chapter
Information
Ovarian Stimulation , pp. 158 - 165
Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ferrero, H, García-Pascual, CM, Gómez, R, et al. Dopamine receptor 2 activation inhibits ovarian vascular endothelial growth factor secretion in vitro: implications for treatment of ovarian hyperstimulation syndrome with dopamine receptor 2 agonists. Fertil Steril 2014;101(5):14111418.CrossRefGoogle ScholarPubMed
Nastri, CO, Ferriani, RA, Rocha, IA, Martins, WP. Ovarian hyperstimulation syndrome: pathophysiology and prevention. J Assist Reprod Genet 2010;27:121128.Google Scholar
Aboulghar, MA, Mansour, RT. Ovarian hyperstimulation syndrome: classifications and critical analysis of preventive measures. Hum Reprod Update 2003;9:275289.Google Scholar
Mathur, RS, Akande, AV, Keay, SD, Hunt, LP, Jenkins, JM. Distinction between early and late ovarian hyperstimulation syndrome. Fertil Steril 2000;73(5):901907.Google Scholar
Gebril, A, Hamoda, H, Mathur, R. Outpatient management of severe ovarian hyperstimulation syndrome: a systematic review and a review of existing guidelines. Hum Fertil (Camb) 2018;21(2):98105.CrossRefGoogle Scholar
Smith, LP, Hacker, MR, Alper, MM. Patients with severe ovarian hyperstimulation syndrome can be managed safely with aggressive outpatient transvaginal paracentesis. Fertil Steril 2009;92(6):19531959.CrossRefGoogle ScholarPubMed
Rizk, B, Aboulghar, MA. Classification, pathophysiology and management of ovarian hyperstimulation syndrome. In: Brinsden, P, ed. A Textbook of In-vitro Fertilization and Assisted Reproduction, 2nd ed. Carnforth-Lancs, UK. The Parthenon Publishing Group; 1999:131155.Google Scholar
Lainas, GT, Kolibianakis, EM, Sfontouris, IA, et al. Outpatient management of severe early OHSS by administration of GnRH antagonist in the luteal phase: an observational cohort study. Reprod Biol Endocrinol 2012;10:69.CrossRefGoogle ScholarPubMed
Lainas, GT, Kolibianakis, EM, Sfontouris, IA, et al. Pregnancy and neonatal outcomes following luteal GnRH antagonist administration in patients with severe early OHSS. Hum Reprod 2013;28(7):19291942.Google Scholar
Deng, L, Li, XL, Ye, DS, et al. A second dose of GnRHa in combination with luteal GnRH antagonist may eliminate ovarian hyperstimulation syndrome in women with ≥30 follicles measuring ≥11 mm in diameter on trigger day and/or pre-trigger peak estradiol exceeding 10 000 pg/mL. Curr Med Sci 2019;39(2):278284.Google Scholar
Abramov, Y, Fatum, M, Abrahomov, D, et al. Hydroxyethyl starch versus human albumin for the treatment of severe ovarian hyperstimulation syndrome: a preliminary report. Fertil Steril 2001;75:12281230.Google Scholar
Gamzu, R, Almog, B, Levin, Y, et al. Efficacy of hydroxyethyl starch and Haemaccel for the treatment of severe ovarian hyperstimulation syndrome. Fertil Steril 2002;77:13021303.Google Scholar
Minami, T, Mph, , Yamana, H, et al. Artificial colloids versus human albumin for the treatment of ovarian hyperstimulation syndrome: a retrospective cohort study. Int J Reprod Biomed 2019;17(10):709716.Google Scholar
Rizk, B. Ovarian Hyperstimulation Syndrome: Epidemiology, Pathophysiology, Prevention and Management. Cambridge, UK: Cambridge University Press; 2006.Google Scholar
Fabregues Tassies, D, Reverter, JC, Reverter, JC, et al. Prevalence of thrombophilia in women with severe ovarian hyperstimulation syndrome and cost-effectiveness of screening. Fertil Steril 2004;81:989995.Google Scholar
Mikhail, S, Rizk, RMB, Nawar, MG, Rizk, CB. Thrombophilia and implantation failure. In: Rizk, B, Garcia-Velasco, JA, Sallam, HN, Makrigiannakis, A, eds. Infertility and Assisted Reproduction. Cambridge, UK: Cambridge University Press; 2008:407415.Google Scholar
Serour, GI, Aboulghar, MA, Mansour, R, et al. Complications of medically assisted conception in 3,500 cycles. Fertil Steril 1998;70:638642.CrossRefGoogle Scholar
Lee, TH, Liu, CH, Huang, CC, et al. Serum anti-mullerian hormone and estradiol levels as predictors of ovarian hyperstimulation syndrome in assisted reproduction technology cycles. Hum Reprod 2008;23:160167.CrossRefGoogle ScholarPubMed
Lambalk, CB, Banga, FR, Huirne, JA, et al. GnRH antagonist versus long agonist protocols in IVF: a systematic review and meta-analysis accounting for patient type. Hum Reprod Update 2017;23(5):560579.Google Scholar
Çağlar Aytaç, P, Kalaycı, H, Yetkinel, S, et al. Effect of pigtail catheter application on obstetric outcomes in in vitro fertilization/intracytoplasmic sperm injection pregnancies following hyperstimulation syndrome. Turk J Obstet Gynecol 2017;14(2):9499.Google Scholar
Abuzeid, M, Warda, H, Joseph, S, et al. Outpatient management of severe ovarian hyperstimulation syndrome (OHSS) with placement of pigtail catheter. Facts Views Vis Obgyn 2014;6(1):3137.Google Scholar
Ozgun, MT, Batukan, C, Oner, G, et al. Removal of ascites up to 7.5 liters on one occasion and 45 liters in total may be safe in patients with severe ovarian hyperstimulation syndrome. Gynecol Endocrinol 2008;24(11):656658.Google Scholar
Agarwal, N, Ghosh, S, Bathwal, S, Chakravarty, B. Large-volume paracentesis, up to 27 L, with adjuvant vaginal cabergoline in the case of severe ovarian hyperstimulation syndrome with successful pregnancy outcome: a case report. J Hum Reprod Sci 2017;10(3):235237.Google Scholar
Raziel, A, Friedler, S, Schachter, M, et al. Transvaginal drainage of ascites as an alternative to abdominal paracentesis in patients with severe ovarian hyperstimulation syndrome, obesity, and generalized edema. Fertil Steril 1998;69(4):780783.Google Scholar
Brinsden, PR, Wada, I, Tan, SL, et al. Diagnosis, prevention and management of ovarian hyperstimulation syndrome. Br J Obstet Gynecol 1995;102:767772.Google Scholar
Practice Committee of the American Society for Reproductive Medicine. Electronic address: ; Practice Committee of the American Society for Reproductive Medicine. Prevention and treatment of moderate and severe ovarian hyperstimulation syndrome: a guideline. Fertil Steril 2016;106(7):16341647.Google Scholar
Tan, BK, Mathur, R. Management of ovarian hyperstimulation syndrome. Produced on behalf of the BFS Policy and Practice Committee. Hum Fertil (Camb) 2013;16(3):151159.CrossRefGoogle Scholar
Busso, CE. Prevention of OHSS – dopamine agonists. Reprod Biomed Online 2009;19(1):4351.CrossRefGoogle ScholarPubMed
Spitzer, D, Wirleitner, B, Steiner, H, Zech, NH. Adnexal torsion in pregnancy after assisted reproduction – case study and review of the literature. Geburtshilfe Frauenheilkd 2012;72(8):716720.Google ScholarPubMed
Tsai, HC, Kuo, TN, Chung, MT, et al. Acute abdomen in early pregnancy due to ovarian torsion following successful in vitro fertilization treatment. Taiwan J Obstet Gynecol 2015;54(4):438441.Google Scholar
Busso, C, Fernandez-Sanchez, M, Garcia-Velasco, JA, et al. The non-ergot derived dopamine agonist quinagolide in prevention of early ovarian hyperstimulation syndrome in IVF patients: a randomized, double-blind, placebo-controlled trial. Hum Reprod 2010;25(4):9951004. doi: 10.1093/humrep/deq005.Google Scholar
Kanayama, S, Kaniwa, H, Tomimoto, M, et al. Laparoscopic detorsion of the ovary in ovarian hyperstimulation syndrome during the sixth week of gestation: a case report and review. Int J Surg Case Rep 2019;59:5053.Google Scholar
Orvieto, R, Vanni, VS. Ovarian hyperstimulation syndrome following GnRH agonist trigger-think ectopic. J Assist Reprod Genet 2017;34(9):11611165. doi: 10.1007/s10815-017-0960-0.Google Scholar
Weiss, A, Beck-Fruchter, R, Golan, J, et al. Ectopic pregnancy risk factors for ART patients undergoing the GnRH antagonist protocol: a retrospective study. Reprod Biol Endocrinol 2016;14:12.Google Scholar
Chang, HJ, Suh, CS. Ectopic pregnancy after assisted reproductive technology: what are the risk factors? Curr Opin Obstet Gynecol 2010;22(3):202207.Google Scholar
Navot, D, Bergh, PA, Laufer, N. Ovarian hyperstimulation syndrome in novel reproductive technologies: prevention and treatment. Fertil Steril 1992;58:249261.Google ScholarPubMed
Fiedler, K, Ezcurra, D. Predicting and preventing ovarian hyperstimulation syndrome (OHSS): the need for individualized not standardized treatment. Reprod Biol Endocrinol 2012;10:32.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×