Ovarian hyperstimulation syndrome and its relation to pregnancy

Vytautas Abraitis1, Saulė Kržčonavičiūtė1, Marija Vaitkevičiūtė2

1 Department of Obstetrics and Gynecology, Medical Academy, Lithuanian University of Health Sciences, Eivenių g. 2, LT-50161 Kaunas, Lithuania

2 Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus g. 9, LT-44307 Kaunas, Lithuania

                                                                                                                

Abstract

Introduction: Ovarian Hyperstimulation Syndrome (OHSS) is an iatrogenic complication manifested by suprafysiological ovarian stimulation. This syndrome is commonly related to assisted reproduction. OHSS has been associated with an increased risk of miscarriage, multiple pregnancies, and more severe clinical course of the syndrome. However, there are few studies examining the relationship between OHSS and pregnancy, and more consistent studies are needed. The aim – to discuss the characteristics of OHSS and it‘s possible links with pregnancy. Research method: systematic literature review was conducted. Articles, describing OHSS and its links to pregnancy, were selected. The review was done using the electronic database Pub-Med (Medline). Results: OHSS prevention is selected individually based on risk factors, anti-müllerian hormone concentration, and number of tertiary follicles. Mild to moderate OHSS may regress spontaneously and treatment is not always necessary. Patients who develop signs of severe OHSS should be hospitalized and treated with medication and (or) surgery. In case of unclear pathogenesis of the disease, only symptomatic treatment is possible. A correlation was observed between OHSS and an increased risk of miscarriage, preterm birth, gestational hypertension and low birth weight. Conclusions: OHSS is an iatrogenic complication that can occur at different stages and degrees due to variety of risk factors and prevention. Mild to moderate OHSS is often a transient condition, however, severe OHSS can be potentially life-threatening. The complications associated with OHSS are miscarriage and preterm birth, although there are also associations between this syndrome and gestational hypertension as well as low birth weight. 

Keywords: ovarian hyperstimulation syndrome, OHSS treatment, pregnancy.