This text, authored by eminent international experts, comprehensively explores OHSS, with a focus on prevention, complications, and treatment strategies, incorporating the latest scientific advances.
Ovarian hyperstimulation syndrome (OHSS) is a serious and potentially life-threatening complication of ovarian stimulation in women undergoing in vitro fertilization (IVF). It is triggered solely by human chorionic gonadotrophin (hCG), used for final oocyte maturation (early OHSS), or by endogenous hCG produced by the implanted blastocyst (late OHSS). Although its incidence may have decreased due to advances in ovarian stimulation protocols, OHSS remains a significant concern in the context of rising global ART cycles. This text, authored by eminent international experts, comprehensively explores OHSS, with a focus on prevention, complications, and treatment strategies, incorporating the latest scientific advances.
- Offers a state-of-the-art overview of all clinical aspects of OHSS
- Provides focused OHSS guidance for gynecologists, reproductive specialists and healthcare professionals
- Highlights the role of modern ovarian stimulation protocols in reducing OHSS
Part 1 Introduction: Definition 1.1 ART and OHSS Development
(Early-Late) 1.2 Clinical Manifestations of Ovarian Hyperstimulation Syndrome
1.3 Epidemiology of OHSS 1.4 Complications of Ovarian Hyperstimulation
Syndrome Part 2 Pathophysiology of OHSS 2.1 Pathophysiology of Ovarian
Hyperstimulation Syndrome: The Role of Corpus Luteum and Vascular
Permeability 2.2 Genetic Causes of OHSS Part 3 Classification of OHSS 3.1
Ovarian Hyperstimulation Syndrome: Historical Classification Systems 3.2
Modern OHSS Classification Systems Part 4 Prediction of OHSS 4.1 Risk Factors
for OHSS 4.2 OHSS Prediction Part 5 Primary Prevention: OHSS Reduction
Strategies 5.1 Types and Doses of Gonadotrophins and Alternative Strategies
to Reduce OHSS Incidence 5.2 Coasting and hCG Dose Reduction 5.3
Gonadotropin-Releasing Hormone (GnRH) Antagonist Protocols 5.4 Embryo and
Oocyte Cryopreservation 5.5 In Vitro Maturation Navigating Success and
Safety Part 6 Secondary Prevention: OHSS Elimination Strategies 6.1 GnRH
Agonist Triggering and "Freeze-All" Strategy 6.2 Navigating through OHSS with
GnRH Agonist Triggers and Low-Dose hCG for Luteal Support 6.3 OHSS
Elimination: Alternative Agents for Final Oocyte Maturation Part 7 Tertiary
Prevention: Outpatient Management 7.1 Luteal GnRH Antagonist Administration
for Management of Established Severe OHSS 7.2 Dopamine Agonists 7.3
Glucocorticoids and OHSS Part 8 Management of Established OHSS 8.1 Management
of Late OHSS 8.2 Criteria for Hospitalization and Inpatient Management
George Lainas MD is a Reproductive Gynecologist at Eugonia Assisted Reproductive Unit, Athens, Greece, and Senior Deputy of the Special Interest Group in Reproductive Endocrinology of the European Society of Human Reproduction and Embryology. Dr Lainas is also a member of the Guideline Development Group of Ovarian Stimulation and also a member of the European Committee for the development of Key Performance Indicators (KPIs) in Ovarian Stimulation.His research work has made a significant contribution in the improvement of treatment protocols and prevention of severe complications in IVF; he is a regularly invited speaker at international scientific conferences and seminars and a reviewer in peer-reviewed scientific journals.
Tryfon G Lainas MD, PhD, is Director of the Eugonia Assisted Reproductive Unit, Athens, Greece; the former head of the department of endoscopic surgery at 'IASO' maternity hospital, he also organized the 1st International Seminar of Perinatal Medicine on the biology of reproduction in 1992.
