Management of ovarian hyperstimulation syndrome
نویسندگان
چکیده
Consequences of stimulation of the ovaries include the serious and potentially life-threatening condition of ovarian hyperstimulation syndrome (OHSS). This can occur with any type of ovulation induction or superovulation therapy for assisted conception procedures. The development of OHSS can be reduced by the cautious use of preparations, careful monitoring of stimulation cycles, and prediction of ‘at risk’ patients. This overview will describe the syndrome and its pathophysiology in order to understand appropriate preventative strategies and management options. The pathophysiologic hallmark of OHSS is a sudden increase in vascular permeability which results in the development of a massive extravascular exudate. This exudate accumulates primarily in the peritoneal cavity, causing protein-rich ascites. Loss of fluid into the third space causes a profound fall in intravascular volume, hemoconcentration, and suppression of urine formation. Loss of protein into the third space causes a fall in plasma oncotic pressure, which results in further loss of intravascular fluid. Secondary hyperaldosteronism occurs and causes salt retention. Eventually peripheral edema develops. OHSS occurs after overstimulated ovaries have been exposed to hCG. The condition therefore results most commonly when sensitive (usually polycystic) ovaries are exposed to excessive quantities of FSH and then to hCG. That severe OHSS is often associated with pregnancy is probably related to the persistence of hCG in this situation. Even when the ovaries have been severely overstimulated, OHSS can be prevented by avoiding exposure of the ovaries to LH and/or hCG.
منابع مشابه
P-177: Effect of Mannitol Therapy Protocol on Ovarian Hyperstimulation Syndrome Management;Comparison between PCO and Non-PCO Patients
متن کامل
I-34: New Management Options for Ovarian Hyperstimulation Syndrome
Ovarian Hyperstimulation Syndrome (OHSS) is a rare complication of super ovulation and in vitro fertilization (IVF). Although our understanding of its pathophysiology is incomplete, induction of development of multiple follicles, perturbation of the renin angiotensin system and exposure to luteinizing hormone (LH) or human chorionic gonadotropin (hCG) are essential contributing factors to its d...
متن کاملI-31: Antihistamine & Ovarian Hyperstimulation syndrome
Background: Ovarian hyperstimulation syndrome (OHSS) is a rare iatrogenic complication of ovulation stimulation. The pathogenesis of OHSS is uncertain. The crucial event appears to be an increase in capillary permeability by vasoactive mediators such as cytokine and histamine. The aim of this study is to evaluate the role of loratadine (antihistamine) in preventing ovarian hyperstimulation synd...
متن کاملComparison of Cabergoline with Quinagolide in Prevention of Severe Ovarian Hyperstimulation Syndrome among Patients Undergoing Intracytoplasmic Sperm Injection:A randomized trial
a:4:{s:9:"Objective";s:192:"The aim of the present study was to compare Quinagolide with Cabergoline in prevention of ovarian hyper stimulation syndrome among high risk women undergoing intra cytoplasmic sperm injection.";s:19:"MaterialsAndMethods";s:948:"Material and Methods: This Randomized clinical trial study was performed from March 2015 to February 2017. One hundred and twenty six women u...
متن کاملMyrrh for treatment of severe vulvar edema in ovarian hyperstimulation syndrome☆
Background Severe vulvar edema is a rare entity occurring with ovarian hyperstimulation syndrome. This edema can be incapacitating; causing pain and limited patient mobility. With the usual conservative approach, vulvar edema can take several days to resolve. Aim The aim of this case report is to describe the use of local myrrh for the management of severe vulvar edema associated with ovarian...
متن کامل