Clinically significant and severe hyperstimulation develops in 2-4% of patients during IVF
(Ovarian hyperstimulation syndrome) OHSS is a severe complication of ovulation stimulation and IVF. The incidence of OHSS in its milder form is 20 to 30%, while clinically significant and severe hyperstimulation develops in 2 to 4% of patients during IVF.
According to the onset of symptoms, there are two forms of OHSS:
- early: ≤ 10 days after oocyte aspiration (AJS oocyte aspiration)
- late: ≥ 10 days after AJS.
The classification of OHSS is not strict because the disease can progress rapidly, changing stages of expression and thus the risk posing to the patient.
Prevention of OHSS
Ovarian hyperstimulation cannot be eliminated entirely, but carefully analysing risk factors can significantly reduce the frequency. Patient demographic characteristics are the basis of primary prevention of OHSS, and the choice of ovulation stimulation procedures for IVF treatment represents secondary preventive measures. All measures are part of a personalized ovulation stimulation scheme, with which our clinic has many years of experience.
Treatment of OHSS
Treatment of OHSS should be individualized and depends on the severity and progression of the disease. The moderate stage can be treated on an outpatient basis; more severe forms of hyperstimulation require hospitalization.
Treatment and choice of medication (procedures) depend on the decision for fresh ET or forgoing transfer and using freeze-all technology. For severe OHSS, rapid disease progression and early onset of severe symptoms, freezing of all embryos (oocytes) is always recommended. Then, the therapeutic options are wider, and the non-receptive endometrium is bypassed.
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