Prevention and management of ovarian hyperstimulation syndrome
Journal
Best Practice and Research: Clinical Obstetrics and Gynaecology
Journal Volume
26
Journal Issue
6
Pages
817-827
Date Issued
2012
Author(s)
Abstract
Ovarian hyperstimulation syndrome is a relatively common complication of ovarian stimulation and can be life-threatening. The pathophysiology of ovarian hyperstimulation syndrome is characterised by increased capillary permeability, leading to leakage of fluid from the vascular compartment, with third space fluid accumulation and intravascular dehydration. The combined use of a gonadotrophin-releasing hormone antagonist protocol with gonadotrophin-releasing hormone agonist triggering and oocyte and embryo freezing has considerable promise in preventing ovarian hyperstimulation syndrome. Women with severe ovarian hyperstimulation syndrome require hospitalisation for more careful monitoring and treatment. Transvaginal paracentesis can be used as an outpatient treatment to prevent the need for hospitalisation. The inhibition of vascular permeability seems to be a novel therapeutic approach to preventing and treating ovarian hyperstimulation syndrome. ? 2012 Elsevier Ltd. All rights reserved.
SDGs
Other Subjects
acetylsalicylic acid; albumin; buserelin; cabergoline; chorionic gonadotropin; dalteparin; dopamine; dopamine receptor stimulating agent; enoxaparin; follitropin; gonadorelin agonist; gonadorelin antagonist; heparin; hetastarch; leuprorelin; low molecular weight heparin; metformin; opiate; paracetamol; progesterone; recombinant luteinizing hormone; triptorelin; vasculotropin; article; blood vessel permeability; capillary permeability; coasting; cryopreservation; cycle cancellation; dehydration; disease severity; drug dose comparison; embryo freezing; female; fertilization in vitro; freezing; hemoconcentration; human; intensive care; intracytoplasmic sperm injection; intravascular dehydration; kidney failure; kidney perfusion; low drug dose; lung function; oocyte freezing; oocyte maturation; outpatient care; ovary hyperstimulation; ovary polycystic disease; ovulation; pain; paracentesis; pathophysiology; patient monitoring; pleura effusion; priority journal; prophylaxis; risk assessment; risk reduction; single drug dose; thromboembolism; thrombosis prevention; vascularization; Female; Gonadotropin-Releasing Hormone; Hormone Antagonists; Humans; Ovarian Hyperstimulation Syndrome; Ovulation Induction; Paracentesis; Risk Assessment
Type
journal article