Abstract: Objective To evaluate the efficacy of a risk factor-guided continued out-of-hospital management protocol in preventing ovarian hyperstimulation syndrome(OHSS). Methods A retrospective-prospective hybrid study design was adopted. First, a retrospective cohort analysis(428 cases)was conducted to identify independent risk factors for OHSS. logistic regression analysis was employed to examine contributing factors for OHSS occurrence, with receiver operating characteristic(ROC)curve analysis used to evaluate the predictive efficacy of risk factors. Subsequently, a prospective trial was performed, enrolling 79 patients in the intervention group and 74 in the control group. The intervention group received dynamic management through a WeChat platform including high-protein dietary guidance, symptom monitoring, and real-time consultation, while the control group maintained traditional management. The χ2 test was used to compare hospitalization rates, and the independent samples t-test to analyze differences in ovarian diameter changes(ultrasound-measured), sleep quality, and quality of life scores. Results The retrospective analysis identified the number of retrieved oocytes(cut-off value 11.50, AUC=0.825)and trigger-day E2 levels(cut-off value 2 995.50 pg/mL, AUC=0.788)as independent risk factors for OHSS(P<0.001). In the prospective trial, the intervention group showed significantly lower hospitalization rates(3.8% vs. 13.5%, P=0.031). The experimental group exhibited a significantly lower degree of deterioration in sleep quality scores compared to the control group ［median(IQR): 4.00(2.00,6.00)vs. 0(-1.00,2.00), P<0.001］. Moreover, the experimental group demonstrated statistically significant improvements in both the total quality-of-life scores ［55.15(47.61,65.63)vs. 70.59(57.35,83.82)］ and the core module scores［54.69(44.53,66.67)vs. 70.83(58.33,85.42)］ compared to the control group(both P<0.001). No statistically significant differences were found in post-intervention ovarian diameter changes between groups(P>0.05). Conclusion A continued out-of-hospital management guided by risk factor screening effectively reduces hospitalization rates for OHSS and alleviates the physical and psychological burden on patients.

Key words: Ovarian hyperstimulation syndrome, Risk factor, Continuity of out-of-hospital management, Hospitalization rate, Pittsburgh sleep quality index, Fertility quality of life questionnaire