Ovarian Hyperstimulation Syndrome

A complication of OVULATION INDUCTION in infertility treatment. It is graded by the severity of symptoms which include OVARY enlargement, multiple OVARIAN FOLLICLES; OVARIAN CYSTS; ASCITES; and generalized EDEMA. The full-blown syndrome may lead to RENAL FAILURE, respiratory distress, and even DEATH. Increased capillary permeability is caused by the vasoactive substances, such as VASCULAR ENDOTHELIAL GROWTH FACTORS, secreted by the overly-stimulated OVARIES.

Also Known As:

Ovarian Hyperstimulation Syndrome, Familial Gestational Spontaneous; Hyperstimulation Syndrome, Ovarian; Hyperstimulation Syndromes, Ovarian; Ovarian Hyperstimulation Syndromes

Networked: 1363 relevant articles (96 outcomes, 144 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Polycystic Ovary Syndrome (Syndrome, Stein-Leventhal)
2.	Ascites
3.	Anovulation
4.	Insulin Resistance
5.	Cysts

Experts

1.	Pellicer, Antonio: 20 articles (09/2015 - 11/2002)
2.	Humaidan, Peter: 19 articles (05/2020 - 07/2010)
3.	Orvieto, Raoul: 17 articles (01/2021 - 10/2004)
4.	Kol, Shahar: 13 articles (11/2020 - 05/2003)
5.	Simón, Carlos: 12 articles (09/2015 - 11/2002)
6.	Griesinger, Georg: 9 articles (01/2021 - 04/2006)
7.	Chen, Shee-Uan: 9 articles (11/2020 - 07/2003)
8.	Gómez, Raúl: 9 articles (09/2015 - 11/2002)
9.	Blockeel, Christophe: 8 articles (01/2022 - 01/2011)
10.	Kolibianakis, E M: 8 articles (01/2019 - 03/2006)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Ovarian Hyperstimulation Syndrome:

1.	Gonadotropin-Releasing Hormone (GnRH)FDA Link 05/01/2014 - "Gonadotropin releasing hormone agonist triggers are very effective in eliminating early-onset ovarian hyperstimulation syndrome (OHSS). " 02/01/2003 - "As for GnRHa, GnRH antagonists have been proven effective to prevent the LH surge and to reduce the incidence of severe ovarian hyperstimulation syndrome in controlled ovarian stimulation cycles." 01/01/2020 - "The cumulative analysis showed that GnRH-a addition for luteal supports significantly improved live birth rate (relative risk [RR] = 1.52; 95% CI 1.20-1.94; p = 0.0006), the clinical pregnancy rate (RR 1.21; 95% CI 1.11-1.33; p < 0.0001), ongoing pregnancy rate (RR 1.18; 95% CI 1.06-1.32; p = 0.004), pregnancy rate (RR 1.36; 95% CI 1.01-1.82; p = 0.04), implantation rate (RR 1.44; 95% CI 1.17-1.77; p = 0.0007), and multiple pregnancy rate (RR 1.40; 95% CI 1.04-1.88; p = 0.03) in comparison with control, but not for the incidence of ovarian hyperstimulation syndrome (RR 0.96; 95% CI 0.32-2.89; p = 0.94). " 11/01/2016 - "The use of a GnRH agonist with a reduced dose of hCG in high responders demonstrated luteal phase support with improved pregnancy rates, similar to those after conventional hCG and a low risk of ovarian hyperstimulation syndrome (OHSS). " 04/01/2015 - "However, the short duration of the LH surge with the GnRH-a trigger (approximately 34 hours) has been shown to be beneficial for preventing ovarian hyperstimulation syndrome in GnRH antagonist in vitro fertilization (IVF) cycles when compared with the prolonged elevation of hCG (≥6 days) after exposure to an hCG bolus. "
2.	Cabergoline FDA LinkGeneric 02/01/2018 - "To assess the efficacy of coasting alone, cabergoline alone, or combining both interventions for preventing ovarian hyperstimulation syndrome (OHSS) among high-risk patients undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment cycles. " 11/01/2013 - "The use of cabergoline and coasting are both effective in reducing the risk of ovarian hyperstimulation syndrome (OHSS). " 01/01/2021 - "This study describes a rare case of moderate ovarian hyperstimulation syndrome which has been managed and treated with high-dose cabergoline. " 02/01/2018 - "Randomized trial of combined cabergoline and coasting in preventing ovarian hyperstimulation syndrome during in vitro fertilization/intracytoplasmic sperm injection cycles." 10/01/2015 - "Cabergoline for preventing ovarian hyperstimulation syndrome in women at risk undergoing in vitro fertilization/intracytoplasmic sperm injection treatment cycles: A randomized controlled study."
3.	GonadotropinsIBA 01/01/2015 - "It is as effective as gonadotropins in terms of pregnancy and live birth rates, but without the risks of ovarian hyperstimulation syndrome and multiple pregnancies. " 11/01/2014 - "During assisted reproductive techniques, AMH assay is very useful choosing the ovarian stimulation protocol and the dose of gonadotropins to begin with, in order to limit the risks of ovarian hyperstimulation syndrome or on the other hand, cancellation of cycles due to poor ovarian response. " 01/28/2022 - "Since a minimal or even zero dose of gonadotropins are required in the IVM procedure, the occurrence of ovarian hyperstimulation syndrome (OHSS) is eliminated. " 04/01/2011 - "The subject of the study is to compare the clinical characteristics of recombinant gonadotropins versus urinary ones focused on the daily dose of FSH achieving FSH threshold and the risk of multifollicular development in ovulation induction before intrauterine insemination, number of follicles and oocytes, the risk of ovarian hyperstimulation syndrome (OHSS), total consumption of FSH, cost effectiveness and expected pregnancy rate during in vitro fertilization technique. " 03/01/2011 - "Studies have shown that ovulation and pregnancy rates are comparable between ovulation induction with gonadotropins and LOD, but LOD avoids the risks of multiple pregnancy and ovarian hyperstimulation syndrome. "
4.	Hormones (Hormone)IBA 12/01/2012 - "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. " 08/01/2020 - "Gonadotrophin releasing hormone agonist (GnRHa) trigger is effective in the induction of oocyte maturation and prevention of Ovarian Hyperstimulation Syndrome (OHSS) on IVF cycles using antagonist protocol.What" 03/01/2016 - "Gonadotrophin releasing hormone agonist (GnRHa) trigger is effective in the induction of oocyte maturation and prevention of ovarian hyperstimulation syndrome during IVF treatment. " 09/01/2021 - "Our study aims to evaluate the diagnostic performance of a high-sensitivity picoAnti-Müllerian Hormone (picoAMH) for predicting ovarian response in women undergoing controlled ovarian hyperstimulation and occurrence of ovarian hyperstimulation syndrome. " 01/01/2015 - "The aim of this study is to investigate the potential role of attenuated anti-Müllerian hormone signaling in the pathogenesis of ovarian hyperstimulation syndrome (OHSS). "
5.	Vascular Endothelial Growth Factor A (Vascular Endothelial Growth Factor)IBA 04/01/2010 - "Although mechanistic evidence is not provided, the pivotal role of VEGF in ovarian hyperstimulation syndrome prompts investigation of TZDs as a novel treatment for this condition." 01/01/2022 - "Studies suggest that ovarian hyperstimulation syndrome (OHSS) can be treated by reducing the level of vascular endothelial growth factor (VEGF). " 02/01/2017 - "In this study the association of vascular endothelial growth factor -460C/T and +405 G/C polymorphisms and susceptibility to ovarian hyperstimulation syndrome was evaluated. " 03/01/2004 - "The aim of this study was to assess the effect of withholding gonadotrophins (coasting) during controlled ovarian stimulation (COS) on individual follicle concentrations of follicular fluid vascular endothelial growth factor (VEGF) in women at high risk of developing ovarian hyperstimulation syndrome (OHSS). " 11/01/2001 - "[Preliminary study on the role of vascular endothelial growth factor in pathogenesis of ovarian hyperstimulation syndrome]."
6.	Chorionic Gonadotropin (Human Chorionic Gonadotropin)FDA LinkGeneric 10/01/2016 - "Abbreviations ART: assisted reproductive technology; BMI: body mass index; FET: frozen-thawed embryo transfer; HCG: human chorionic gonadotropin; IVF: in-vitro fertilization; IVF-ET: in-vitro fertilization and embryo transfer; OHSS: ovarian hyperstimulation syndrome; RCTs: randomized controlled trials. " 04/01/2011 - "The aim of the study is to decrease the risk of the development of ovarian hyperstimulation syndrome (OHSS) at high response donors by the replacement of Pregnyl 10 000 IU i.m. " 01/01/2022 - "Ovarian hyperstimulation syndrome (OHSS) is traditionally associated with fertility treatments and results in elevated human chorionic gonadotropin (βhCG) levels and fluid shifts to extravascular compartments. " 07/20/2020 - "In our patient's case, endogenous human chorionic gonadotropin following the start of controlled ovarian stimulation may have caused late-onset ovarian hyperstimulation syndrome. " 07/20/2020 - "Most cases of ovarian hyperstimulation syndrome are of an early-onset type, which occurs shortly after injection of human chorionic gonadotropin. "
7.	Human Serum Albumin FDA LinkGeneric 01/01/2002 - "Meta-analysis of the five included trials demonstrated significant reduction in severe ovarian hyperstimulation syndrome on administration of human albumin (odds ratio was 0.28 (95% CI 0.11 to 0.73). " 01/01/2000 - "Meta-analysis of the three included trials demonstrated significant reduction in severe ovarian hyperstimulation syndrome on administration of human albumin (common odds ratio 0.1, 95% confidence interval 0.03 to 0.39). " 06/01/2008 - "Role of human albumin in ovarian hyperstimulation syndrome." 10/01/2007 - "We aimed to clarify the efficiency of IV human albumin in the prevention of ovarian hyperstimulation syndrome (OHSS). " 10/01/2007 - "Human albumin does not prevent ovarian hyperstimulation syndrome in assisted reproductive technology program: a prospective randomized placebo-controlled double blind study."
8.	AlbuminsIBA 08/01/1997 - "To determine the efficacy of IV albumin in the prevention of severe ovarian hyperstimulation syndrome (OHSS). " 05/01/1996 - "To compare the efficacy of administration i.v. albumin to prevent severe ovarian hyperstimulation syndrome (OHSS) in patients undergoing ovarian stimulation for IVF with a standard policy of cryopreserving all embryos and to assess the impact of the two methods of treatment on pregnancy rates (PRs). " 11/01/2003 - "Intravenous albumin does not prevent moderate-severe ovarian hyperstimulation syndrome in high-risk IVF patients: a randomized controlled study." 09/01/2001 - "The questionable use of albumin for the prevention of ovarian hyperstimulation syndrome in an IVF programme: a randomized placebo-controlled trial." 07/01/1994 - "Intravenous albumin for the prevention of severe ovarian hyperstimulation syndrome in an in vitro fertilization program: a prospective, randomized, placebo-controlled study."
9.	Progesterone FDA LinkGeneric 01/01/2012 - "hCG and progesterone produce the best results and are comparable or at best a slight edge to hCG but the latter is associated with too high a risk for ovarian hyperstimulation syndrome. " 05/01/2001 - "Since progesterone is as effective as hCG for luteal phase support but provides a higher safety with regard to ovarian hyperstimulation syndromes, and vaginal progesterone is as effective as intramuscular progesterone, vaginal progesterone should be the standard choice for luteal phase support. " 10/05/2011 - "There was a significantly higher risk of ovarian hyperstimulation syndrome (OHSS) when hCG was used (Peto OR 3.62, 95% CI 1.85 to 7.06).There were eight studies (875 women) in the second comparison, progesterone versus placebo or no treatment. " 01/01/2009 - "While ovarian hyperstimulation syndrome is associated with human chorionic gonadotrophin (HCG), studies suggest that exogenous progesterone provides necessary luteal support in patients undergoing IVF. " 01/01/2022 - "In case of the risk of ovarian hyperstimulation syndrome, premature progesterone rise, non-optimal endometrial growth, or supernumerary embryos, cryopreservation with subsequent frozen embryo transfer (FET) was indicated. "
10.	Letrozole (Femara)FDA LinkGeneric 01/12/2023 - "However, despite the promising findings reported by several studies, to date Letrozole is not yet officially mentioned in the guidelines for "Prevention and Treatment of moderate and severe ovarian hyperstimulation syndrome". " 01/01/2017 - "Effect of letrozole on moderate and severe early-onset ovarian hyperstimulation syndrome in high-risk women: a prospective randomized trial." 01/12/2023 - "Letrozole and Ovarian Hyperstimulation Syndrome (OHSS): A Promising Prevention Strategy." 10/01/2022 - "Evaluation of The Effect of Letrozole in the Ovarian Hyperstimulation Syndrome Prevention in Participants at Risk of Treatment with Ovulation-Stimulating Drugs:A Randomized Controlled Trial." 01/01/2020 - "There was2 ovarian hyperstimulation syndrome in the letrozole group; the incidence of ovarian hyperstimulation syndrome in the HMG group was 12.5%. "

Therapies and Procedures

1.	Therapeutics 09/01/2015 - "Efficacy of Kisspeptin-54 to Trigger Oocyte Maturation in Women at High Risk of Ovarian Hyperstimulation Syndrome (OHSS) During In Vitro Fertilization (IVF) Therapy." 12/01/2021 - "Regression of signs and symptoms of spontaneous ovarian hyperstimulation syndrome after 12 weeks of therapy. " 01/01/2021 - "To present current possibilities of the prevention and therapy of ovarian hyperstimulation syndrome (OHSS). " 01/01/2021 - "Current possibilities in the prevention and therapy of ovarian hyperstimulation syndrome." 01/01/2021 - "Ovarian hyperstimulation syndrome (OHSS) is a common complication caused by ovulatory stimulation therapy, which manifests as an increase in ovarian volume, an increase in the number of oocytes retrieved, and increased vascular permeability throughout the body and especially in ovarian tissue. "
2.	Laser Therapy (Surgery, Laser) 07/01/1995 - "Our purpose was to examine the efficacy of laser vaporization of the ovarian surface in polycystic ovary disease to reduce repeated ovarian hyperstimulation syndrome and thereby improve pregnancy outcome. " 07/01/1995 - "Laser vaporization is promising for the prevention of ovarian hyperstimulation syndrome and improving pregnancy outcome in patients with polycystic ovary disease who have previously had ovarian hyperstimulation syndrome." 03/01/1993 - "These results suggest that ovarian laser vaporization is very useful when clomiphene citrate fails in PCOD, and has no risk of ovarian hyperstimulation syndrome or multiple gestation, which is frequently observed in ovulation induction with drugs. "
3.	Autologous Blood Transfusion 11/01/1992 - "Autotransfusion of the ascitic fluid in the treatment of severe ovarian hyperstimulation syndrome." 08/01/1998 - "[Integral treatment of severe ovarian hyperstimulation syndrome by means of autotransfusion of ascitic fluid and intravenous infusion of albumin]." 11/01/2012 - "Autotransfusion of protein in concentrated ascites for the treatment of severe ovarian hyperstimulation syndrome was effective and safe." 01/01/2000 - "We investigated prospectively the clinical efficacy of a newly developed continuous autotransfusion system of ascites (CATSA) without protein supplement in patients with severe ovarian hyperstimulation syndrome (OHSS). "
4.	Length of Stay 01/01/2004 - "To assess the possibility that number of days of hospital stay increases with an increasing number of conceptuses in patients with ovarian hyperstimulation syndrome (OHSS). " 01/01/1993 - "Intensive IV fluid therapy and transvaginal aspiration of ascitic fluid are safe and effective in improving symptoms, preventing complications, and shortening the hospital stay in severe ovarian hyperstimulation syndrome."
5.	Peritoneovenous Shunt 01/01/2002 - "Dynamic changes of the immunoglobulins in patients with severe ovarian hyperstimulation syndrome: efficacy of a novel treatment using peritoneo-venous shunt."