Ovarian hyperstimulation syndrome - risk reduction strategies

Key content Ovarian hyperstimulation syndrome (OHSS) is a complication of pharmacological ovarian stimulation as part of fertility treatment, with moderate to severe OHSS occurring in 1%-5% of assisted reproductive technology (ART) cycles. Focus has moved towards adopting strategies to prevent the development of OHSS in women identified as high risk, with such measures being implemented before, during and after treatment completion. Strategies that can be implemented to prevent the development of OHSS include pre-treatment selection of appropriateovarian stimulation protocol; the use of adjuvant treatmentsduring ovarian stimulation that can reduce disease severity, forexample, dopamine agonists, use of an agonist trigger; andstrategies that can be implemented after transvaginal eggcollection, for example, elective embryo cryopreservation. Surveillance during ovarian stimulation to can help to identify evolving OHSS.Learning objectives To be aware of the risk of OHSS in those undergoing fertility treatment. To appreciate the importance of preventing moderate to severe OHSS. To be able to identify risk factors for OHSS and adopt strategies to prevent its development. To understand the principles of the management of OHSS.