Ovarian hyperstimulation syndrome: pathophysiology, staging, prediction and prevention

Abstract

Objective To identify, appraise and summarize the current evidence regarding the pathophysiology, staging, prediction and prevention of ovarian hyperstimulation syndrome (OHSS). Methods

Effect of human papilloma virus infection onin‐vitrofertilization outcome: systematic review and meta‐analysis

“…It comprises a group of small DNA viruses that have been associated with benign epithelial lesions and precancerous and/or cancerous states in both partners 1,2 . Infertility is a very common problem, affecting 10-30% of couples of reproductive age 3,4 and in-vitro fertilization (IVF) is frequently used to treat it 5 . HPV infection is thought to have a negative impact on the outcome of IVF 6,7 .…”

Ultrasound and hematological changes during early luteal phase in women at high risk for developing ovarian hyperstimulation syndrome

“…However, despite the increasing use of a GnRH agonist trigger (5.2-36.1% of cases worldwide), hCG administration remains the most popular triggering option 9,10 . There have been several proposals for diagnosing and classifying OHSS since its initial description in 1967 1,4,6,[11][12][13][14][15][16][17][18][19][20][21] . These classification systems have widespread acceptance and have formed the basis of various official guidelines (Royal College of Obstetricians and Gynaecologists 22 and American Society for Reproductive Medicine 6 ).…”

Current Medical Strategies in the Prevention of Ovarian Hyperstimulation Syndrome

“…Current evidence demonstrates that age, antral follicle count and anti-müllerian hormone levels have proved as the best methods of predicting high ovarian response before starting COS. Although estradiol (E2) levels were previously less reliable in prediction of OHSS during ovulation stimulation 7 , currently E2 concentrations, the number of medium/large follicles on the day of hCG and the number of retrieved oocytes are regarded as reliable markers of high ovarian response 8 . Th ere is high-quality evidence that replacing hCG by GnRH agonists and moderate-quality evidence that antagonist protocols, dopamine agonists and mild stimulation reduce the occurrence of OHSS.…”

“…Th ere is high-quality evidence that replacing hCG by GnRH agonists and moderate-quality evidence that antagonist protocols, dopamine agonists and mild stimulation reduce the occurrence of OHSS. However, evidence for the eff ect of other interventions is of low/very low quality 8 . Accordingly, the objective of the present review is to analyze the eff ectiveness and safety of medical strategies that currently may be justifi ably utilized in the prevention of OHSS.…”