Journal of Shandong University (Health Sciences) ›› 2019, Vol. 57 ›› Issue (10): 13-19.doi: 10.6040/j.issn.1671-7554.0.2019.639

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Prevention and treatment of ovarian hyperstimulation syndrome in assisted reproductive therapy

SHI Yuhua, JIANG Qi   

  1. Center for Reproductive Medicine, Shandong University;
    National Research Center for Assisted Reproductive Technology and Reproductive Genetics;
    The Key Laboratory of Reproductive Endocrinology(Shandong University), Ministry of Education;
    Shandong Provincial Clinical Medicine Research Center for Reproductive Health, Jinan 250100, Shandong, China
  • Published:2022-09-27

Abstract: Ovarian hyperstimulation syndrome(OHSS)is one of the common, complex iatrogenic complications after human assisted technology(ART). Nowadays, the pathological mechanism of OHSS is unclear. One generally accepted hypothesis is that an increase in the permeability of capillaries causes fluid leakage into the third lacuna, thus causing systematic hemodynamic change. The main risk factors of OHSS include young age, low weight, high level of estradiol(E2), polycystic ovary syndrome(PCOS), previous episodes of OHSS, and so on. The prevention of OHSS relies on the monitoring of high-risk groups and the rational use of exogenous gonadotropins. The treatment of moderate and severe OHSS is mainly symptomatic treatment to reduce the occurrence of serious complications.

Key words: Ovarian hyperstimulation syndrome, Assisted reproductive technology, Controlled ovarian hyperstimulation, Prevention and therapy

CLC Number: 

  • R711.75
[1] Forman RG, Frydman R, Egan D, et al. Severe ovarian hyperstimulation syndrome using agonists of gonadotropin-releasing hormone for in vitro fertilization: a European series and a proposal for prevention[J]. Fertil Steril, 1990, 53(3): 502-509.
[2] MacDougall MJ, Tan SL, Jacobs HS. In vitro fertilization and the ovarian hyperstimulation syndrome[J]. Human Reproduction, 1992, 7(5): 579-600.
[3] Ho VNA, Braam SC, Pham TD, et al. The effectiveness and safety of in vitro maturation of oocytes versus in vitro fertilization in women with a high antral follicle count[J]. Hum Reprod, 2019, 34(6): 1055-1064.
[4] Zeng C, Shang J, Jin AM, et al. The effect of luteal GnRH antagonist on moderate and severe early ovarian hyperstimulation syndrome during in vitro fertilization treatment: a prospective cohort study[J]. Arch Gynecol Obstet, 2019, 300(1): 223-233.
[5] Li S, Zhou D, Yin T, et al. Dual trigger of triptorelin and HCG optimizes clinical outcome for high ovarian responder in GnRH-antagonist protocols[J]. Oncotarget, 2018, 9(4): 5337-5343.
[6] Delbaere A, Smits G, De Leener A, et al. Understanding ovarian hyperstimulation syndrome[J]. Endocrine, 2005, 26(3): 285-290.
[7] Humaidan P, Quartarolo J, Papanikolaou EG. Preventing ovarian hyperstimulation syndrome: guidance for the clinician[J]. Fertil Steril, 2010, 94(2): 389-400.
[8] Zhai J, Liu J, Zhao S, et al. Kisspeptin-10 inhibits OHSS by suppressing VEGF secretion[J]. Reproduction, 2017, 154(4): 355-362.
[9] Ferrero H, García-Pascual CM, Gómez R, et al. Dopamine receptor 2 activation inhibits ovarian vascular endothelial growth factor secretion in vitro: implications for treatment of ovarian hyperstimulation syndrome with dopamine receptor 2 agonists[J]. Fertil Steril, 2014, 101(5): 1411-1418.
[10] Palumbo A, Ávila J, Naftolin F. The ovarian renin-angiotensin system(OVRAS): a major factor in ovarian function and disease[J]. Reprod Sci, 2016, 23(12): 1644-1655.
[11] Herr D, Bekes I, Wulff C. Local renin-Angiotensin system in the reproductive system[J]. Front Endocrinol(Lausanne), 2013, 4: 150. doi: 10.3389/fendo.2013.00150.
[12] Whelan JG 3rd, Vlahos NF. The ovarian hyperstimulation syndrome[J]. Fertil Steril, 2000, 73(5): 883-896.
[13] Miller I, Chuderland D, Grossman H, et al. The dual role of PEDF in the pathogenesis of OHSS: negating both angiogenic and inflammatory pathways[J]. J Clin Endocrinol Metab, 2016, 101(12): 4699-4709.
[14] 蔺莉, 魏丽惠. 吲哚美辛治疗卵巢过度刺激综合征的实验研究[J]. 中国妇产科临床杂志, 2004, 5(2): 135-137. LIN Li, WEI Lihui. The effect of indomethacin on ovarian hyperstimulation syndrome of rats[J]. Chinese Journal of Clinical Obstetrics Gynecology, 2004, 5(2): 135-137.
[15] 赵菊美. 吲哚美辛治疗卵巢过度刺激综合征的疗效[J]. 浙江临床医学, 2013, 7: 1049-1050.
[16] Lee TH, Liu CH, Huang CC, et al. Serum anti-Mullerian hormone and estradiol levels as predictors of ovarian hyperstimulation syndrome in assisted reproduction technology cycles[J]. Hum Reprod, 2007, 23(1): 160-167.
[17] Chan WS. The ‘ART’of thrombosis: a review of arterial and venous thrombosis in assisted reproductive technology[J]. Curr Opin Obstet Gynecol, 2009, 21(3): 207-218.
[18] Chan WS, Ginsberg JS. A review of upper extremity deep vein thrombosis in pregnancy: unmasking the ‘ART’ behind the clot[J]. J Thromb Haemost, 2010, 4(8): 1673-1677.
[19] 赵晓鹏, 陈桂芝, 常飞, 等. 卵巢过度刺激综合征并发血栓栓塞[J]. 生殖与避孕, 2015, 35(9): 644-649. ZHAO Xiaopeng, CHEN Guizhi, CHANG Fei, et al. Ovarian hyperstimulation syndrome complicating with thrombosis[J]. Reproduction and Contraception, 2015, 35(9): 644-649.
[20] Practice Committee of the American Society for Reproductive Medicine. Prevention and treatment of moderate and severe ovarian hyper stimulation syndrome: a guideline[J]. Fertil Steril, 2016, 106(7): 1634-1647.
[21] Ashrafi M, Bahmanabadi A, Akhond MR, et al. Predictive factors of early moderate/severe ovarian hyperstimulation syndrome in non-polycystic ovarian syndrome patients: a statistical model[J]. Arch Gynecol Obstet, 2015, 292(5): 1145-1152.
[22] Johnson MD, Williams SL, Seager CK, et al. Relationship between human chorionic gonadotropin serum levels and the risk of ovarian hyper-stimulation syndrome[J]. Gynecol Endocrinol, 2014, 30(4): 294-297.
[23] Howles CM, Alam V, Tredway D, et al. Factors related to successful ovulation induction in patients with WHO group II anovulatory infertility[J]. Reprod Biomed Online, 2010, 20(2): 182-190.
[24] Choux C, Barberet J, Ginod P, et al. Severe ovarian hyperstimulation syndrome modifies early maternal serum beta-human chorionic gonadotropin kinetics, but obstetrical and neonatal outcomes are not impacted[J]. Fertil Steril, 2017, 108(4): 650-658.
[25] Mathur RS, Tan BK. British Fertility Society Policy and Practice Committee: Prevention of ovarian hyperstimulation syndrome[J]. Hum Fertil(Camb), 2014, 17(4): 257-268.
[26] Reljic M, Vlaisavljevic V, Gavric V, et al. Number of oocytes retrieved and resulting pregnancy. Risk factors for ovarian hyperstimulation syndrome[J]. J Reprod Med, 1999, 44(8): 713-718.
[27] Jayaprakasan K, Chan Y, Islam R, et al. Prediction of in vitro fertilization outcome at different antral follicle count thresholds in a prospective cohort of 1 012 women[J]. Fertil Steril, 2012, 98(3): 657-663.
[28] Nargund G, Hutchison L, Scaramuzzi R, et al. Low-dose HCG is useful in preventing OHSS in high-risk women without adversely affecting the outcome of IVF cycles[J]. Reprod Biomed Online, 2007, 14(6): 682-685.
[29] Fischer D, Reisenbüchler C, Rösner S, et al. Avoiding OHSS: controlled ovarian low-dose stimulation in women with PCOS[J]. Geburtshilfe Frauenheilkd, 2016, 76(6): 718-726.
[30] Abbara A, Islam R, Clarke SA, et al. Clinical parameters of ovarian hyperstimulation syndrome following different hormonal triggers of oocyte maturation in IVF treatment[J]. Clin Endocrinol(Oxf), 2018, 88(6): 920-927.
[31] Mansour R, Aboulghar M, Serour G, et al. Criteria of a successful coasting protocol for the prevention of severe ovarian hyperstimulation syndrome[J]. Hum Reprod, 2005, 20(11): 3167-3172.
[32] DAngelo A, Amso NN, Brown J. Coasting(withholding gonadotrophins)for preventing ovarian hyperstimulation syndrome[J]. Cochrane Database Syst Rev, 2011, 66(2): CD002811.
[33] 范华蕊, 张洋, 郭情情, 等. 2008~2017年体外受精/卵胞浆内单精子显微注射周期取消新鲜胚胎移植的原因构成与变化[J]. 山东大学学报(医学版), 2018, 56(9): 47-53. FAN Huarui, ZHANG Yang, GUO Qingqing, et al. Analysis on the proportion and changes of causes for cancellation of fresh embryo transfer from 2008 to 2017[J]. Journal of Shandong University(Health Sciences), 2018, 56(9): 47-53.
[34] Shin JJ, Jeong Y, Nho E. Clinical outcomes of frozen embryo transfer cycles after freeze-all policy to prevent ovarian hyperstimulation syndrome[J]. Obstet Gynecol Sci, 2018, 61(4): 497-504.
[35] Roque M, Haahr T, Geber S, et al. Fresh versus elective frozen embryo transfer in IVF/ICSI cycles: a systematic review and meta-analysis of reproductive outcomes[J]. Hum Reprod Update, 2019, 25(1): 2-14.
[36] Zhang W, Xiao X, Zhang J, et al. Clinical outcomes of frozen embryo versus fresh embryo transfer following in vitro fertilization: a meta-analysis of randomized controlled trials[J]. Arch Gynecol Obstet, 2018, 298(2): 259-272.
[37] Venetis CA, Kolibianakis EM, Toulis KA, et al. Intravenous albumin administration for the prevention of severe ovarian hyperstimulation syndrome: a systematic review and meta-analysis[J]. Fertil Steril, 2011, 95(1): 188-196.
[38] Ben-Chetrit A, Eldar-Geva T, Gal M, et al. The questionable use of albumin for the prevention of ovarian hyperstimulation syndrome in an IVF programme: a randomized placebo-controlled trial[J]. Hum Reprod, 2001, 16(9): 1880-1884.
[39] Al-Inany HG. Human albumin is effective in prevention of severe OHSS[J]. Acta Obstet Gynecol Scand, 2001, 80(10): 878-882.
[40] Ghahiri A, Mogharehabed N, Movahedi M, et al. Evaluation of intravenous hydroxylethyl starch, intravenous albumin 20%, and oral cabergoline for prevention of ovarian hyperstimulation syndrome in patients undergoing ovulation induction[J]. J Res Med Sci, 2015, 20(7): 692-696.
[41] Youssef MA, Mourad S. Volume expanders for the prevention of ovarian hyperstimulation syndrome[J]. Cochrane Database Syst Rev, 2016, 8(8): CD001302.
[42] Isikoglu M, Berkkanoglu M, Senturk Z, et al. Human albumin does not prevent ovarian hyperstimulation syndrome in assisted reproductive technology program: a prospective randomized placebo- controlled double blind study[J]. Fertil Steril, 2007, 88(4): 982-985.
[43] Ferraretti AP, Gianaroli L, Diotallevi L, et al. Dopamine treatment for severe ovarian hyperstimulation syndrome[J]. Hum Reprod, 1992, 7(2): 180-183.
[44] Basu S, Nagy JA, Pal S, et al. The neurotransmitter dopamine inhibits angiogenesis induced by vascular permeability factor/vascular endothelial growth factor[J]. Nat Med, 2001, 7(5): 569-574.
[45] Morris RS, Paulson RJ. Increased angiotensin-converting enzyme activity in a patient with severe ovarian hyperstimulation syndrome[J]. Fertil Steril, 1999, 71(3): 562-563.
[46] Leitao VM, Moroni RM, Seko LM, et al. Cabergoline for the prevention of ovarian hyperstimulation syndrome: systematic review and meta-analysis of randomized controlled trials[J]. Fertil Steril, 2014, 101(3): 664-675.
[47] Leitao VM, Moroni RM, Seko LM, et al. Cabergoline for the prevention of ovarian hyperstimulation syndrome: systematic review and meta-analysis of randomized controlled trials[J]. Fertil Steril, 2014, 101(3): 664-675.
[48] Lim KS, Son WY, Yoon SH, et al. IVM/F-ET in stimulated cycles for the prevention of ohss[J]. Fertil Steril, 2002, 78(3): S10-S10.
[49] 杨爱军, 王钦, 牛焕付, 等. 卵母细胞体外成熟在IVF-ET周期中降低OHSS风险中的应用[J]. 生殖医学杂志, 2013, 22(11): 851-854. YANG Aijun, WANG Qin, NIU Huanfu, et al. Application of oocytes in vitro maturation for preventing ovarian hyperstimulation syndrome in IVF-ET cycles[J]. J Reprod Med, 2013, 22(11): 851-854.
[50] Roque M, Lattes K, Serra S, et al. Fresh embryo transfer versus frozen embryo transfer in in vitro fertilization cycles: a systematic review and meta-analysis[J]. Fertil Steril, 2013, 99(1): 156-162.
[51] Bosch E, Ezcurra D. Individualised controlled ovarian stimulation(iCOS): maximising success rates for assisted reproductive technology patients[J]. Reprod Biol Endocrinol, 2011, 9(1): 82-82.
[52] 宋荣, 李寿梅, 石金月, 等. 促性腺激素释放激素拮抗剂在防治早发型中重度卵巢过度刺激综合征的应用[J]. 中华生殖与避孕杂志, 2018, 38(3): 175-180. SNOG Rong, LI Shoumei, SHI Jinyue, et al. Application of gonadotropin—releasing hormone antagonist in the prevention and treatment to fearly ovarian hyperstimulation syndrome[J]. Chinese Journal of Reproduction and Contraception, 2018, 38(3): 175-180.
[53] 吕小蓉. 取卵后应用来曲唑预防卵巢过度刺激综合征(OHSS)的临床效果分析[J]. 实用妇科内分泌杂志(电子版), 2018, 5(29): 15-16,18. LV Xiaorong. The analysis of clinical effect of using letrozole to prevent OHSS[J]. Journal of Practical Gynecologic Endocrinology, 2018, 5(29): 15-16,18.
[54] Tso LO, Costelo MF, Albuquerque LE, et al. Metformin treatment before and during IVF or ICSI in women with polycystic ovary syndrome[J]. Cochrane Database Syst Rev, 2014, 11: CD006105.
[55] Vaárnagy A, Boódis J, Maánfai Z, et al. Low-dose aspirin therapy to prevent ovarian hyperstimulation syndrome[J]. Fertil Steril, 2010, 93(7): 2281-2284.
[56] Ruan X, Song J, Gu M, et al. Effect of Diane-35, alone or in combination with orlistat or metformin in Chinese polycystic ovary syndrome patients[J]. Arch Gynecol Obstet, 2018, 297(6): 1557-1563.
[57] Mu L, Zhao Y, Li R, et al. Metabolic characteristics of normal weight central obesity phenotype polycystic ovary syndrome women: a large-scale national epidemiological survey[J]. Reprod Biomed Online, 2018, 37(4): 498-504.
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