Ovarian Hyperstimulation Syndrome (OHSS) ∞ Area

Ovarian Hyperstimulation Syndrome (OHSS)

Meaning

Ovarian Hyperstimulation Syndrome (OHSS) is a systemic complication of controlled ovarian stimulation, characterized by an exaggerated ovarian response to gonadotropins. This results in ovarian enlargement and increased vascular permeability, leading to fluid extravasation into third spaces like peritoneal, pleural, and pericardial cavities.

Context

It arises within the context of assisted reproductive technologies, specifically following controlled ovarian stimulation, a crucial step in procedures like in vitro fertilization (IVF). This syndrome represents a severe, albeit uncommon, iatrogenic complication of pharmacological interventions aimed at inducing multifollicular development for oocyte retrieval.

Significance

Clinical recognition of OHSS is paramount due to its potential for significant morbidity and, in rare cases, mortality. Its presence necessitates careful patient monitoring, fluid management, and, at times, hospitalization, directly influencing the safety and success rates of fertility treatments. Early identification and risk stratification are critical for preventing progression to severe forms.

Mechanism

The primary mechanism involves an acute increase in vascular permeability, largely mediated by vascular endothelial growth factor (VEGF) and other vasoactive substances released by stimulated ovarian follicles. This leads to a shift of fluid from the intravascular compartment into extravascular spaces, causing ascites, pleural effusions, and hemoconcentration, thereby increasing the risk of thromboembolic events.

Application

In clinical practice, OHSS management varies with severity, from outpatient symptomatic relief for mild cases to intensive inpatient care for severe presentations. Protocols involve close monitoring of fluid balance, electrolyte levels, renal function, and respiratory status. Interventions include paracentesis or thoracentesis for significant effusions and anticoagulation for thrombosis prophylaxis.

Metric

Assessment of OHSS severity relies on several objective metrics, including daily weight measurement, abdominal circumference, serial ultrasound evaluation of ovarian size and fluid accumulation, and laboratory parameters such as hematocrit, serum electrolytes, creatinine, and liver function tests. Estradiol levels and the number of developing follicles during stimulation also serve as predictive markers for risk stratification.

Risk

Improper management or an exaggerated response to ovarian stimulation carries substantial risks. These include severe abdominal pain, nausea, vomiting, and potentially life-threatening complications such as renal dysfunction, acute respiratory distress syndrome, thromboembolic events, and ovarian torsion. Such risks underscore the necessity for meticulous patient selection, individualized stimulation protocols, and vigilant post-retrieval surveillance.

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∞ Ovarian Hyperstimulation Syndrome (OHSS)

HRTioJuly 26, 2025

Ovarian Hyperstimulation Syndrome (OHSS)

Meaning

Context

Significance

Mechanism

Application

Metric

Risk

Can Targeted Peptide Therapies Support Female Reproductive Health?

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