Ovarian hyperstimulation syndrome (OHSS) is a serious and potentially life-threatening complication of ovarian stimulation in women undergoing IVF. It is triggered solely by human chorionic gonadotrophin (hCG), used for final oocyte maturation (early OHSS), or by endogenous hCG produced by the implanted blastocyst (late OHSS). Although its incidence may have decreased due to advances in ovarian stimulation protocols, OHSS remains a significant concern in the context of rising global ART cycles. This text, authored by eminent international experts, comprehensively explores OHSS, with a focus on prevention, complications, and treatment strategies, incorporating the latest scientific advances.
*Offers a state-of-the-art overview of all clinical aspects of OHSS
*Provides focused OHSS guidance for gynecologists, reproductive specialists and healthcare professionals
*Highlights the role of modern ovarian stimulation protocols in reducing OHSS
1.Introduction – Definition 1.1 ART and OHSS Development (Early - Late OHSS) 1.2 Clinical Manifestations of OHSS 1.3 Epidemiology of OHSS l 1.4 Complications of OHSS Rong Li 2. Pathophysiology of OHSS 2.1 The Role of Corpus Luteum and Vascular Permeability 2.2 Genetic Causes of OHSS 3.1 Classification of OHSS 3.1 Historical Classification Systems 3.2 Modern Classification Systems 4. Prediction of OHSS 4.1 Risk Factors for OHSS 4.2 OHSS Prediction Models 5.Primary Prevention: OHSS Reduction Strategies 5.1 GnRH Antagonist Protocols 5.2 Coasting and hCG Dose Reduction 5.3 Types and Doses of Gonadotrophins & Alternative Strategies 5.4 Embryo and Oocyte Cryopreservation 5.5 Oocyte In Vitro Maturation 6. Secondary Prevention: OHSS Elimination Strategies 6.1 GnRH Agonist Trigger and Freeze-All Strategy 6.2 GnRH Agonist and Low-Dose hCG in Luteal Phase 6.3 Alternative Agents for Final Oocyte Maturation (rLH – Kisspeptin) 7.Tertiary Prevention: Outpatient Management 7.1 Luteal GnRH Antagonist Administration 7.2 Dopamine Agonists 7.3 Glucocorticoid Administration 8. Management of Established OHSS 8.1 Management of Late OHSS 8.2 Criteria for Hospitalization – Inpatient Treatment
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