Hostname: page-component-76fb5796d-vvkck Total loading time: 0 Render date: 2024-04-26T21:28:05.046Z Has data issue: false hasContentIssue false
  • English
  • Français

The ovarian hyperstimulation syndrome

Published online by Cambridge University Press:  03 June 2009

L Gianaroli ,
AP Ferraretti  and
A Fiorentino
L Gianaroli*
Affiliation:
SISMER, Reproductive Medicine Unit, Bologna, Italy
AP Ferraretti
Affiliation:
SISMER, Reproductive Medicine Unit, Bologna, Italy
A Fiorentino
Affiliation:
SISMER, Reproductive Medicine Unit, Bologna, Italy
*
SISMER, Reproductive Medicine Unit, V. Mazzini 12, 1-40137 Bologna, Italy.
Get access Rights & Permissions [Opens in a new window]

Extract

Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication induced by exogenous administration of substances that are used to stimulate follicular growth and ovulation. There has only been one reported incidence of a spontaneous occurrence of OHSS and that was in 1992. The crucial event in the development of the syndrome is the administration of human chorionic gonadotropin (HCG), although several studies have reported the onset of OHSS after gonadotropin stimulation despite withholding HCG. OHSS is represented by a broad spectrum of clinical and laboratory manifestations which, in the severest form, can induce a life-threatening condition.

Type
Research Article
Information
Reproductive Medicine Review , Volume 5 , Issue 3 , October 1996 , pp. 169 - 184
Copyright
Copyright © Cambridge University Press 1996

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

1Zalel, Y, Katz, Z, Caspi, B, Ben-Hur, H, Dgani, R, Insler, V. Spontaneous ovarian hyperstimulation syndrome concomitant with spontaneous pregnancy in a woman with polycystic disease. Am J Obstet Gynecol 1992; 167: 122–24.CrossRefGoogle Scholar
2Lipitz, S, Zion, BR, Bider, D, Shalev, J, Mashiach, S. Quintuplet pregnancy and third degree ovarian hyperstimulation despite withholding human chorionic gonadotrophin. Hum Reprod 1991; 6: 1478–79.CrossRefGoogle ScholarPubMed
3Allegra, A, Termine, N, Raineri, L, Corselli, F, Traina, MC, Giannola, C. Iperstimolazione ovarica e gravidanza gemellare in una paziente in trattamento con analogo del GnRH e gonadotropine senza somministrazione di midcycle HCG. Riv Ost Gin Perin 1991; 2; 209–11.Google Scholar
4Mozes, M, Bogokowsky, H, Antebi, E et al. Thromboembolic phenomena after ovarian stimulation with human gonadotrophins. Lancet 1965; ii: 1213–15.CrossRefGoogle Scholar
5Schenker, JG, Weinstein, D. Ovarian hyperstimulation syndrome: a current survey. Fertil Steril 1978; 30: 255–68.Google ScholarPubMed
6Daniel, Y, Yarin, Y, Oren, M, Peyser, MR, Lessing, JB. Ovarian hyperstimulation syndrome manifests as acute unilateral hydrothorax. Hum Reprod 1995; 10: 1684–85.CrossRefGoogle ScholarPubMed
7Phillips, LL, Glanstone, W, Vande, Wiele R. Studies of the coagulation and fibronolytic systems in hyperstimulation syndrome after administration of human gonadotrophins. J Reprod Med 1975; 14: 138–44.Google Scholar
8Ryley, NG, Forman, R, Barlow, D, Fleming, K, Trowell, JM. Liver abnormality in ovarian hyperstimulation syndrome. Hum Reprod 1990; 5: 983–43.CrossRefGoogle ScholarPubMed
9Mashiach, S, Goldenberg, M, Bider, D, Zion, BR, Moran, O. Adnexal torsion of hyperstimulated ovaries in pregnancies after gonadotropin therapy. Fertil Steril 1990; 53: 76–80.CrossRefGoogle ScholarPubMed
10Tulandi, T, Meinnes, RA, Arronet, GH. Ovarian hyperstimulation syndrome following ovulation induction with hMG. Int J Fertil 1984; 29: 113–117.Google Scholar
11Rizk, B, Aboulgar, MA, Mansour, RT, Serour, GL, Amin, Y. Severe ovarian hyperstimulation syndrome: analytical study of twenty-one cases. Hum Reprod 1991; 6: 368–69.Google Scholar
12Grimbizis, G, Tarlatzis, BC, Bontis, J et al. Two cases of ovarian tumours in women who had undergone multiple ovarian stimulation attempts. Hum Reprod 1995; 10: 520–23.CrossRefGoogle ScholarPubMed
13Rabau, E, David, A, Serr, DM, Mashiach, S, Lunefeld, B. Human menopausal gonadotropins for anovulation and sterility: results of 7 years of treatment. Am J Obstet gynecol 1967; 98: 92–98.Google Scholar
14Who Scientific Group. Agents stimulating gonadal functions in the human. Technical Report Series No. 514, Geneva: World Health Organization.Google Scholar
15Golan, A, Ron-El, R, Herman, A, Soffer, Y, Wainrub, Z, Caspi, E. Ovarian hyperstimulation syndrome: an update review. Obstet Gynecol Surv 1989; 44: 430–40.CrossRefGoogle ScholarPubMed
16Navot, D, Bergh, PA, Laufer, N. Ovarian hyperstimulation syndrome in novel reproductive technologies: prevention and treatment. Fertil Steril 1992; 58: 249–61.Google ScholarPubMed
17Bassil, S, Godin, PA, Stallaert, S et al. Ovarian hyperstimulation syndrome: a review. Assist Reprod Rev 1995; 5: 90–95.Google Scholar
18Polishuk, WZ, Schenker, JG. Ovarian overstimulation syndrome. Fertil Steril 1969; 20: 443–52.Google Scholar
19Navot, D, Margalioth, EJ, Laufer, N et al. Direct correlation between plasma renin activity and severity of ovarian hyperstimulation syndrome. Fertil Steril 1987; 48: 57–61.CrossRefGoogle ScholarPubMed
20Goldsman, MP, Pedram, A, Dominguez, CE, Ciuffardi, I, Levin, E, Ash, RH. Increased capillary permeability induced by human follicular fluid: a hypothesis for an ovarian origin of the hyperstimulation syndrome. Fertil Steril 1995; 63: 268–72.CrossRefGoogle ScholarPubMed
21Balasch, J, Arroyo, V, Carmona, F et al. Severe ovarian hyperstimulation syndrome: role of peripheral vasodilatation. Fertil Steril; 56: 1077–83.CrossRefGoogle Scholar
22Bergh, PA, Navot, D. Ovarian hyperstimulation syndrome: a review of pathophysiology. J Assist Reprod Gen 1992; 9: 429–38.CrossRefGoogle ScholarPubMed
23Schenker, JG, Polishuk, WZ. An experimental model of ovarian hyperstimulation syndrome. In Tischner, M, Pilc, J (eds.) Proceedings of the International Congress on Animal Reproduction, Drukarnia Naukowa, Krakow, 1976: 635–42.Google Scholar
24Yarali, H, Fleige-Zahradka, BG, Ho, Yuen B, McComb, PF. The ascites in the ovarian hyperstimulation syndrome does not originate from the ovary. Fertil Steril 1993; 59: 657–61.CrossRefGoogle Scholar
25Engel, T, Jewelewitz, R, Dyrenfurth, I, Speroff, L, Vande, Wiele RL. Ovarian hyperstimulation syndrome. Am J Obstet Gynecol 1972; 112: 1052–1060.CrossRefGoogle ScholarPubMed
26Schenker, JG, Polishuk, WZ. The role of prostaglandins in ovarian hyperstimulation syndrome. Eur J Obstet Gynecol Biol Reprod 1976; 6: 47.CrossRefGoogle ScholarPubMed
27Knox, GE. Antihistamine blockade of the ovarian hyperstimulation syndrome. Am J Obstet Gynecol 1974; 118; 992–94.CrossRefGoogle ScholarPubMed
28Haning, RV Jr., Strawn, EY, Nolten, WE. Pathophysiology of the ovarian hyperstimulation syndrome. Obstet Gynecol 1985; 66: 220–24.Google ScholarPubMed
29Ong, ACM, Eisen, V, Rennie, DP et al. The pathogenesis of the ovarian hyperstimulation syndrome (OHS): a possible role for ovarian renin. Clin Endocrinol 1991; 34: 43–49.CrossRefGoogle Scholar
30Istovitz, J, Glorioso, N, Sealey, JE, Rosenwacks, A. Prorenin response to hCG is directly related to the number of ovarian follicles [Abstract]. 18th Annual Meeting of the American Fertility Society/Canadian Fertility and Andrology Society. Toronto, Canada, 1986: 10.Google Scholar
31Katz, FH, Romfh, P. Plasma aldosterone and renin activity during the mentrual cycle. J Clin Endocrinol Metab 1972; 34: 819–21.Google Scholar
32Sealey, JE, Atlas, SA, Gloriosi, N, Manapat, H, Laragh, JH. Cyclical secretion of prorenin during the menstrual cycle: synchronisation with luteinizing hormone and progesterone. Proc Natl Acad Sci USA 1985; 82: 8705–709.CrossRefGoogle Scholar
33Sealey, JE, Glorioso, N, Toth, A, Atlas, SA, Laragh, JH. Stimulation of plasma prorenin by gonadotropic hormones [Letter]. Am J Obstet Gynecol 1985; 153: 596CrossRefGoogle ScholarPubMed
34Glorioso, N, Atlas, SA, Laragh, JH, Jewelewicz, R, Sealey, JE. Prorenin in high concentrations in human follicular fluid. Science 1986; 233: 1422–24.CrossRefGoogle Scholar
35Do, YS, Sherrod, A, Lobo, RA, Paulson, RJ et al. Human ovarian theca cells are a source of renin. Proc Natl Acad Sci USA 1988; 85: 1957–59.Google Scholar
36Morris, RS, Paulson, RJ. The ovarian angiotensin system: recent advances and their relationship to assisted reproductive technologies. Assist Reprod Rev 1993; 3: 88–93.Google Scholar
37Fernandez, LA, Twickler, J, Mead, A. Neovascularization produced by angiotensin II. J Lab Clin Med 1985; 105: 141–45.Google ScholarPubMed
38Delbaere, A, Bergmann, PJM, Gervy-Decoster, C, Staroukine, M, Englert, Y. Angiotensin II immunoreactivity is elevated in ascites during severe ovarian hyperstimulation syndrome: implications for pathophysiology and clinical management. Ferti Steril 1994; 62: 731–37.CrossRefGoogle ScholarPubMed
39Morris, RS, Wong, IL, Kirkman, E, Gentschein, E, Paulson, RJ. Inhibition of ovarian- derived prerenin to angiotensin cascade in the treatment of ovarian hyperstimulation syndrome. Hum Reprod 1995; 10: 1355–58.CrossRefGoogle Scholar
40Zolti, M, Ben-Rafael, Z, Meirom, R, Shemes, M, Bider, D, Mashiach, S, Apte, RN. Cytokine involvement in oocytes and early embryos. Fertil Steril 1991; 56: 265–72.CrossRefGoogle ScholarPubMed
41Motro, B, Itin, A, Sachs, L, Keshet, E. Pattern of interleukin 6 gene expression in vivo suggests a role for this cytokine in angiogenesis. Cell Biol 1991; 87: 3092–96.Google Scholar
42Fukuoka, M, Mori, T, Taii, S, Yasuda, K. Interleukin-1 inhibits luteinization of porcine granulosa cells in culture. Endocrinology 1987; 124: 884–90.CrossRefGoogle Scholar
43Nakamura, Y, Kato, H, Terranova, PF. Interleukin-1 increases thecal progesterone production of preovulatory follicles in cyclic hamster. Biol Reprod 1990; 43: 169–73.CrossRefGoogle Scholar
44Nothnick, WB, Pate, JL. Interleukin-1 is a potent stimulator of prostaglandin synthesis in bovine luteal cells. Biol Reprod 1990; 43: 898–903.CrossRefGoogle ScholarPubMed
45Orvieto, R, Voliovitch, I, Fishman, P, Ben-Rafael, Z. Interleukin-2 and ovarian hyperstimulation syndrome: a pilot study. Hum. Reprool 1995; 10: 24–27.Google Scholar
46Oppenheim, JJ, Ruscetti, F, Faltynek, C. Cytokines. In Stites, DP, Terr, AI (Eds.). Basic and clinical immunology, 7th edn.East Norwalk, CT: Appleton and Lange, 1991: 78.Google Scholar
47Thaler, I, Yoffe, N, Kaftory, JK, Brandes, JM. Treatment of ovarian hyperstimulation syndrome: the physiologic basis for a modified approach. Fertil Steril 1981;36: 110–13.CrossRefGoogle ScholarPubMed
48Todorow, S, Schricker, ST, Siebzehsruebl, E, Neidhardt, B, Wildt, L, Lang, N. von Willebrand Factor: an endothelial marker to monitor in-vitro fertilization patients with ovarian hyperstimulation syndrome. Hum Reprod 1993; 8: 2039–46.Google Scholar
49McClure, N, Healy, DL, Rogers, PAW. Vascular endothelial cell growth factor as permeability agent in ovarian hyperstimulation syndrome. Lancet 1994; 344: 235–36.CrossRefGoogle Scholar
50Senger, DR, Galli, SJ, Dvorak, AM, Peruzzi, CA, Harvey, VS, Dvorak, HF. Tumor cells secrete a vascular permeability factor that promotes accumulation of ascites fluid. Science 1983; 219: 283–85.CrossRefGoogle ScholarPubMed
51Yan, Z, Weich, HA, Bernart, W, Breckwoldt, M, Neulen, J. Vascular endothelial cell growth factor (VEGF) messenger ribonucleic acid (mRNA) expression in luteinized human granulosa cells in-vitro. J Clin Endocrinol Metab 1993; 776: 1723–25.Google Scholar
52Neulen, J, Yan, Z, Rackzek, S et al. Human chorionic gonadotropin-dependent expression of vascular endothelial growth factor/vascular permeability factor in human granulosa cells: importance in ovarian hyperstimulation syndrome. J Clin Endocrinol Metab 1995; 80: 1967–71.Google Scholar
53Delvigne, A, Dubois, M, Battheu, B et al. The ovarian hyperstimulation syndrome in in-vitro fertilization: a Belgian multicentric study. II. Multiple discriminant analysis for risk prediction. Hum Reprod 1993; 8: 1361–66.Google Scholar
54Pattison, HA, Hignett, M, Dunphy, BC, Fleetham, J. Outcome of thaw embryo transfer after cryopreservation of all embryos in patients at risk of ovarian hyperstimulation syndrome. Fertil Steril 1994; 62: 1192–96.Google Scholar
55Feichtinger, W, Kemeter, P. Transvaginal sector scan sonography for needle guided transvaginal follicle aspiration and other application in gynecological routine and research. Fertil Steril 1986; 45: 722–25.Google Scholar
56Mizunuma, H, Andoh, K, Yamada, K, Takagi, T, Kamijo, T, Ibuki, Y. Prediction and prevention of ovarian hyperstimulation by monitoring endogenous luteinizing hormone release during purified follicle-stimulating hormone therapy. Fertil Steril 1992; 58: 46–50.CrossRefGoogle ScholarPubMed
57Gustafson, O, Carlström, K, Nylund, L. Androstenedione as a predictor of ovarian hyperstimulation syndrome. Hum Reprod 1992; 7: 918–21.CrossRefGoogle ScholarPubMed
58Smitz, J, Camus, M, Devroey, P, Erard, P, Wisanto, A, Van Steirteghem, AC. Incidence of severe ovarian hyperstimulation syndrome after GnRH agonist/hMG superovulation for in-vitro fertilization. Hum Reprod 1990; 5: 933–37.CrossRefGoogle ScholarPubMed
59Mordel, N, Schenker, G. Gonadotrophin-releasing hormone agonist and ovarian hyperstimulation syndrome in assisted reproduction. Hum Reprod 1993; 8: 2009–14.Google Scholar
60Sher, G, Salem, R, Feinman, M, Dodge, S, Zouves, C, Knutzen, V. Eliminating the risk of life-endangering complications follwing overstimulation with menotropin fertility agents: a report on women undergoing in vitro fertilization and embryo transfer. Obstet Gynecol 1993; 86: 1009–11.Google Scholar
61Sher, G, Zouves, C, Feinman, M, Maassarani, G. ‘Prolonged coasting’: an effective method for preventing severe ovarian hyperstimulation syndrome in patients undergoing in-vitro fertilization. Hum Reprod 10: 3107–109.Google Scholar
62Barale, E, Manzur, A, Gonzalez-Snau, , Freerick, JL, Asch, RH, Balmaceda, JP. Menotropin coasting for preventing ovarian hyperstimulation syndrome. Presented at the IXth World Congress on In Vitro Fertilization and Assisted Reproduction, Vienna, Austria. J Assist Reprod Genet 1995; 12: 146S-PP-94.Google Scholar
63Schenker, JG. Prevention and treatment of ovarian hyperstimulation. Hum Reprod 1993; 8: 653–59.CrossRefGoogle ScholarPubMed
64Emperaire, JC, Ruffie, A. Triggering ovulation with endogenous luteinizing hormone may prevent the ovarian hyperstimulation syndrome. Hum Reprod 1991; 6: 506–10.CrossRefGoogle ScholarPubMed
65Shalev, E, Gelsevich, Y, Ben-Ami, M. Induction of pre-ovulatory luteinizing hormone surge by gonadotrophin-releasing hormone agonist for women at risk for developing the ovarian hyperstimulation syndrome. Hum Reprod 1994; 9: 417–19.Google Scholar
66Lessing, JB, Amit, A, Libal, Y, Yovel, I, Kogosowski, A, Peyser, MR. Avoidance of cancellation of potential hyperstimulation cycles by conversion to in vitro fertilization-embryo transfer. Fertil Steril 1991; 56: 75–81.Google Scholar
67Amit, A, Yaron, Y, Yovel, I, Peyser, MR, David, MP, Botchan, A, Lessing, JB. Repeated programme reduces the risk of ovarian hyperstimulation syndrome in responders. Hum Reprod 1993; 8: 1184–86.Google Scholar
68Tomazevic, T, Meden-Vrtovec, H. Early timed follicular aspiration prevents severe ovarian hyperstimulation syndrome. J Assist Reprod Genet 1996; 13: 282–86.Google Scholar
69Salat-Baroux, J, Alvarez, S, Antoine, JM et al. Treatment of hyperstimulation during in vitro fertilization. Hum Reprod 1990; 5: 36–39.CrossRefGoogle ScholarPubMed
70Wada, I, Matson, PL, Home, G, Buck, P, Lieberman, BA. Is continuation of a gonadotrophin- releasing hormone agonist (GnRHa) necessary for women at risk of developing the ovarian hyperstimulation syndrome? Hum Reprod 1992; 7: 1090–93.CrossRefGoogle ScholarPubMed
71Balasch, J, Carmona, F, Llach, J, Arroyo, V, Jové, I, Vanrell, JA. Acute prerenal failure and liver dysfunction in a patient with severe ovarian hyperstimulation. Hum Reprod 1990; 5: 348–51.Google Scholar
72Asch, RH, Ivery, G, Goldsman, M, Frederick, JL, Stone, SC, Balmaceda, JP. The use of intravenous albumin in patients at high risk for severe ovarian hyperstimulation syndrome. Hum Reprod 1993; 8: 1015–20.CrossRefGoogle ScholarPubMed
73Isik, AZ, Gokmen, O, Zeyneloglu, HB, Kara, S, Keles, G, Guleki, B. Intravenous albumin prevents moderate-severe ovarian hyperstimulation in in-vitro fertilization patients: a prospective randomized and controlled study. J Assist Reprod Genet Suppl 1995; 12: 54S.Google Scholar
74Morris, RS, Paulson, RJ. Does intravenous albumin prevent ovarian hyperstimulation syndrome? [Letter] Hum Reprod 1995; 9: 753.CrossRefGoogle Scholar
75Mukherjee, T, Copperman, AB, Sandler, B, Bustillo, M, Grunfeld, L. Severe ovarian hyperstimulation despite prophylactic albumin at the time of oocyte retrieval for in vitro fertilization and embryo transfer. Fertil Steril 1995; 64: 641–43.Google Scholar
76Ng, E, Leader, A, Claman, P, Domingo, M, Spence, JEH. Intravenous albumin does not prevent the development of severe ovarian hyperstimulation syndrome in an in-vitro fertilization programme. Hum Reprod 1995; 10: 807–10.Google Scholar
77Morris, RS, Paulson, RJ, Sauer, MV, Lobo, RA. Predictive value of serum oestradiol concentrations and oocyte number in severe ovarian hyperstimulation syndrome. Hum Reprod 1995; 10: 811–14.CrossRefGoogle ScholarPubMed
78Wada, I, Matson, PL, Troup, SA, Morroll, DR, Hunt, L, Lieberman, BA. Does elective cryopreservation of all embryos from women at risk of ovarian hyperstimulation syndrome reduce the incidence of the condition? J Obstet Gynaecol 1993; 100: 265–69.Google ScholarPubMed
79Awonuga, AO, Pittrof, RJ, Zaidi, J et al. Elective cryopreservation of all embryos in women at risk of developing ovarian hyperstimulation syndrome may not prevent the condition but reduces the live birth rate. J Assist Reprod Genet 1996; 13: 401–406.CrossRefGoogle ScholarPubMed
80Rizk, B, Aboulghar, M. Modern management of ovarian hyperstimulation syndrome. Hum Reprod 1991; 6: 1082–87.CrossRefGoogle ScholarPubMed
81Shapiro, AG, Thomas, T, Epstein, M. Management of hyperstimulation syndrome. Fertil Steril 1977; 28: 237–39.CrossRefGoogle ScholarPubMed
82Ferraretti, AP, Gianaroli, L, Diotallevi, L, Festi, C, Trounson, A. Dopamine treatment for severe ovarian hyperstimulation syndrome. Hum Reprod 1992; 7: 180–83.CrossRefGoogle ScholarPubMed
83Ferraretti, AP, Gianaroli, L, Diotaallevi, L, Festi, C, Trounson, A. Letters to the editor. Hum Reprod 1992;7: 1181–82.CrossRefGoogle Scholar