Skip to main content Accessibility help
×
Home
Hostname: page-component-99c86f546-vl2kb Total loading time: 0.396 Render date: 2021-11-30T23:42:24.158Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

15 - Complications of ovulation induction II: ovarian hyperstimulation syndrome, ovarian torsion

Published online by Cambridge University Press:  01 February 2010

Richard P. Dickey
Affiliation:
Louisiana State University
Peter R. Brinsden
Affiliation:
Bourn Hall Clinic, Cambridge
Roman Pyrzak
Affiliation:
The Fertility Institute of New Orleans
Get access

Summary

Introduction

Ovarian hyperstimulation syndrome (OHSS) is characterized by bilateral, multiple follicular and thecalutein ovarian cysts and an acute shift in body fluid distribution resulting in ascites Fig. 15.1. OHSS in patients undergoing controlled ovarian hyperstimulation has been observed to occur in two distinct forms, early onset and late onset, with possibly different predisposing factors. Early OHSS presents 3–7 days after the ovulatory dose of human chorionic gonadotropin (hCG), whereas late OHSS presents 12–17 days after hCG. Early OHSS relates to an “excessive” preovulatory response to stimulation, whereas late-onset OHSS depends on the occurrence of pregnancy, is more likely to be severe and is only poorly related to preovulatory events. Rizk and Smitz, in an analytical study of the factors that influence the incidence of OHSS, found a wide variation among different centers. This is partly because of different definitions of the grades of severity and partly because of the adoption of different criteria for its prevention. The incidence of OHSS has been estimated at 20–33% for mild cases, 3–6% for moderate cases and between 0.1% and 2% for severe cases.

Overview of OHSS classifications

There has been no unanimity in classifying OHSS, and divergent classifications have made comparisons between studies difficult. Aboulghar and Mansour reviewed the classifications used for OHSS over the last four decades and included as many as six categories of severity. The most recent classification was introduced in 1999 by Rizk and Aboulghar.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2009

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.)

Send book to Kindle

To send this book to your Kindle, first ensure no-reply@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 sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent 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
×

Send book to Dropbox

To send 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 sending content to Dropbox.

Available formats
×

Send book to Google Drive

To send 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 sending content to Google Drive.

Available formats
×