Preventing Ovarian Hyperstimulation Syndrome

Extract

The paper by Alvarez et al. (1) in this issue evaluated the role of dopamine agonist cabergoline in prevention of ovarian hyperstimulation syndrome (OHSS) for patients undergoing controlled ovarian hyperstimulation (COH) for in vitro fertilization (IVF).

This editorial covers the following items:

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OHSS is the most serious complication of ovulation induction. In severe forms, the syndrome is characterized by ovarian enlargement, ascites, hydrothorax, electrolyte imbalance, hypovolemia, and oliguria (2). Vascular complications are the most serious complications. They include cerebrovascular thrombosis and arterial thrombosis (3). Respiratory complications include pleural effusion and adult respiratory distress syndrome (4). Renal failure and liver dysfunction were also reported. The condition could be lethal, and mortalities have been reported in rare cases (2).

During the past decade, there was an explosion in the number of COH cycles worldwide, both for IVF/intra-cytoplasmic sperm injection and ovulation induction for ovulatory infertility. In the last report of the American Society for Reproductive Medicine in 2001, 10,8130 cycles of assisted reproductive technology were started in the United States (5), and the last report of European Society of Human Reproduction and Embryology showed that 324,238 cycles of assisted reproductive technology were performed during the year 2002 in Europe (6).