Control Ovarian Hyperstimulation Syndrome (COHS)
Control Ovarian Hyperstimulation Syndrome (COHS) is a serious complication of ovarian stimulation and is characterized by ovarian enlargement, abdominal distension, discomfort, ascites, nausea, vomiting, and, in severe cases, oliguria, liver dysfunction, and respiratory distress syndrome.
The incidence of ovarian hyperresponsiveness has been shown to increase with the number of eggs retrieved based on data from the Society for Assisted Reproductive Technology (SART). Between 2008 and 2010, the incidence of ovarian hyperresponsiveness syndrome was 0.37% in fresh cycles containing 6 to 10 eggs. And 1.67% in fresh cycles containing 16-20 eggs.
The risks of ovarian hyperresponsiveness syndrome must be weighed against the risks and costs of trying further. Most patients do not develop ovarian hyperresponsiveness syndrome. Furthermore, ovarian hyperresponsiveness syndrome is becoming less of a concern because of strategies that have been developed to manage and prevent it.
The use of a GnRH agonist appears to significantly reduce but not eliminate the risk of ovarian hyperresponsiveness syndrome.
Ovarian hyperstimulation syndrome is a serious complication of ovarian stimulation and is characterised by enlarged ovaries, abdominal distention and discomfort, ascites, nausea and vomiting, and, in severe cases, oliguria, i.e. reduced urine output, liver dysfunction and respiratory distress syndrome.
The incidence of OHSS has been shown to increase with the number of oocytes retrieved. On the basis of the Society for Assisted Reproductive Technology (SART) data from 2008–2010, the incidence of OHSS was 0.37% in fresh cycles with six to 10 oocytes and 1.67% in fresh cycles with 16–20 oocytes.
The risk of OHSS must be balanced with the risks and costs of another cycle, however, most patients do not develop OHSS. Moreover, OHSS is becoming less of a concern owing to strategies developed to manage and prevent OHSS. For patients receiving a conventional GnRH antagonist protocol, the use of a GnRH agonist trigger seems to substantially reduce (but not eliminate) the risk of OHSS.
