Ovarian hyperstimulation syndrome

Ovarian hyperstimulation syndrome is a potentially life-threatening syndrome that is predominantly iatrogenic in women receiving gonadotropin therapy. Advances in elucidating the pathophysiology underlying OHSS have allowed improved recognition of patients at risk; therefore, earlier initiation of preventative measures can be undertaken. Once OHSS develops, management is usually supportive. Medical therapy may be indicated in certain circumstances, such as severe intravascular volume depletion and hemoconcentration. Surgical intervention is limited to patients with cyst rupture and adnexal torsion. Conservative techniques sparing the adnexa are usually successful. As research continues to uncover the mechanism of interaction of the various mediators involved in the development of OHSS, the ability to diagnose, prevent, and manage the syndrome will improve, possibly eliminating the most severe sequelae of OHSS.