Assessment of Risk Factors of Ovarian Hyperstimulation Syndrome after Assisted Reproduction

Background: Ovarian hyperstimulation syndrome (OHSS) is a life-threatening complication occurring in stimulated ovar-ian cycles. It is commonly observed in women undergoing controlled ovarian hyperstimulation. (COH) employed during assisted reproductive technology (ART). Aim of Study: Therefore, this study was conducted to ex-plore the risk factors associated with development of OHSS in the patients undergoing ART. Patients and Methods: The study enrolled 113 infertile cases underwent IVF/ICSI. OHSS occurrence was detected and possible risk factors for OHSS were studied. Results: The mean age of OHSS patients was 26.5±4.55 compared 28.52±5.60 in Non OHSS patients, the mean BMI in OHSS patientswas 24.22±5.08 compared to 28.62±5.03 in non OHSS patients. Only 5.6% of those who developed OHSS had history of OHSS before. OHSS patients subject had higherin-cidence of PCOS (83.3% vs. 30.5%) in Non OHSS patients. The antagonist protocol with a GnRH agonist trigger had the lowest incidence of OHSS (2.2%, moderate only) with zero in-cidence of severe or lethal grades, while the long agonist pro-tocol with an hCG trigger had the highest (26%, including both moderate and severe grades). The mean basal AFC was much higher in OHSS patients (22.61±4.20) compared to non OHSS patients (14.02±4.87). Basal AMH was also much higher in OHSS patients compared to non OHSS patients (5.66±0.91 vs. 3.46±2.56). OHSS patients received much higher doses of both FSH&LH (FSH=300±48.50 vs 270.52±73.02) (LH=150±0 vs. 110.03±38.09). OHSS patients had much higher retrieved eggs (median 21) compared to non OHSS patients (median 10). Conclusions: Undergoing ART programs to restore fertili-ty is becoming increasingly widespread, leading to ever-higher numbers of cases being admitted to emergency departments with complications. OHSS is one of the most frequent com-plications Risk factors for OHSS should be considered for any patient seeking for ART. Low threshold for detection of OHSS and application of properpreventive measures should be done. ICU admission should be considered for cases of severe OHSS rather than out-patient for mild cases.