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Ovarian hyperstimulation syndrome
Ovarian hyperstimulation syndrome (OHSS) is a medical condition affecting the ovaries of some women who take fertility medication to stimulate egg growth. Most cases are mild, but rarely the condition is severe and can lead to serious illness or death.
==Classification==
OHSS is divided into the categories mild, moderate, severe, and critical.〔
In mild forms of OHSS the ovaries are enlarged (5–12 cm)〔Textbook of Assisted Reproductive Techniques, Laboratory and Clinical Perspectives, edited by David K. Gardner, 2001〕 and there may be additional accumulation of ascites with mild abdominal distension, abdominal pain,〔 nausea,〔 and diarrhea.〔 In severe forms of OHSS there may be hemoconcentration, thrombosis and distension, oliguria (decreased urine production), pleural effusion, and respiratory distress. Early OHSS develops before pregnancy testing and late OHSS is seen in early pregnancy.
Criteria for severe OHSS include enlarged ovary, ascites, hematocrit > 45%, WBC > 15,000, oliguria, creatinine 1.0-1.5 mg/dl, creatinine clearance > 50 ml/min, liver dysfunction, anasarca.〔 Critical OHSS includes enlarged ovary, tense ascites with hydrothorax and pericardial effusion, hematocrit > 55%, WBC > 25,000, oligoanuria, creatinine > 1.6 mg/dl, creatinine clearance < 50 ml/min, renal failure, thromboembolic phenomena, ARDS.〔
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