Byung-Chul Jee

Risk Factors and Preventive Measures of Ovarian Hyperstimulation Syndrome

Ovarian hyperstimulation syndrome (OHSS) is a significant iatrogenic problem in women undergoing ovarian stimulation and its prevention is a challenging issue. Identification of high-risk patients and assessment of ovarian response, together with the minimal use of gonadotropins and human chorionic gonadotropin (hCG), should be sought before any preventive measures are undertaken for the prevention of OHSS. The use of a gonadotropin-releasing hormone (GnRH) antagonist for pituitary suppression, metformin co-treatment during ovarian stimulation for women with polycystic ovary syndrome, coasting, cryopreservation of all embryos, GnRH agonist triggering in a GnRH antagonist cycle, and the use of hydroxyethyl starch at the time of oocyte pickup are some strategies that may provide some benefit, but it cannot be applied in every cases. Only cycle cancellation by withholding hCG or in vitro maturation cycles guarantee complete avoidance of OHSS. More developments in in vitro maturation cycles and a better understanding of the pathophysiology of OHSS may lead to an improvement in the ability to predict and prevent this serious condition.

Utilisation d’un inhibiteur de l’aromatase (létrozole) combiné aux gonadotrophines dans les cycles d’iiu

Journal de Gynecologie Obstetrique et Biologie de la Reproduction - Vol. 34 - N° SUP7 - p. 6