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Ovarian Hyperstimulation Syndrome (OHSS)

Kimberly E. Liu, MD, MSL and Ellen M. Greenblatt, BSc, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic physiologic complication of controlled ovarian hyperstimulation (COH) (most often related to treatment for infertility).

  • Resu...

DIAGNOSIS

OHSS is a clinical diagnosis based on history, physical exam, US findings, and lab results. 

HISTORY

  • Details of stimulation cycle

    • Medications used

    • Date of oocyte retrieval and embryo transfer

  • Sym...

TREATMENT

GENERAL MEASURES

  • Mild to moderate OHSS: generally managed as outpatient

    • Oral fluid intake of at least 1 L daily of a balanced electrolyte solution (sports drinks)

    • Monitor daily weight, abdomina...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patients discharged from the hospital should be followed by a gynecologist or physician familiar with OHSS until symptom resolution. 

Patient Monitoring

Patients wh...

REFERENCES

1
Lin H, Li Y, Li L, et al. Is a GnRH antagonist protocol better in PCOS patients? A meta-analysis of RCTs. PLoS One.  2014;9(3):e91796. [View Abstract on OvidMedline]
2
Chen CD, Chen SU,...

ADDITIONAL READING

  • Gómez R, Soares SR, Busso C, et al. Physiology and pathology of ovarian hyperstimulation syndrome. Semin Reprod Med.  2010;28(6):448–457.

  • Practice Committee of American Society ...

CODES

ICD10

N98.1 Hyperstimulation of ovaries 

ICD9

256.1 Other ovarian hyperfunction 

SNOMED

129635004 Ovarian hyperstimulation syndrome (disorder) 

CLINICAL PEARLS

  • Patients who have had OHSS are more at risk for OHSS in the future.

  • OHSS is a self-limited disease. Management is mainly supportive.

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