Ovarian hyperstimulation syndrome (OHSS) is a potential but preventable complication in individuals undergoing in vitro fertilization (IVF) treatments. The luteal phase of the natural menstrual cycle is the standard paradigm for the clinical application of assisted reproductive technologies (ART). However, in stimulated cycles, the process of triggering oocyte maturation and the hormonal environment that follows is quite different from the natural cycle. Strategies aimed at replacing hCG for triggering final oocyte maturation and developing the appropriate luteal-phase hormonal environment could all but eliminate the incidence of OHSS in stimulated cycles. Several strategies have been implemented to overcome the OHSS in the luteal phase. Gonadotrophin-releasing hormone agonist (GnRH-a) and progesterone supplementation in the luteal phase are some of the strategies that are widely used. In this chapter, we are solely focusing on strategies that can prevent OHSS in the luteal phase. This chapter concludes that apart from strategies to prevent OHSS development, if possible, individualized protocols should be adopted based on the patient’s needs and risk factors.

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Luteal-Phase Strategies to Prevent Ovarian Hyperstimulation Syndrome (OHSS)

  • Sarah Zaidi

摘要

Ovarian hyperstimulation syndrome (OHSS) is a potential but preventable complication in individuals undergoing in vitro fertilization (IVF) treatments. The luteal phase of the natural menstrual cycle is the standard paradigm for the clinical application of assisted reproductive technologies (ART). However, in stimulated cycles, the process of triggering oocyte maturation and the hormonal environment that follows is quite different from the natural cycle. Strategies aimed at replacing hCG for triggering final oocyte maturation and developing the appropriate luteal-phase hormonal environment could all but eliminate the incidence of OHSS in stimulated cycles. Several strategies have been implemented to overcome the OHSS in the luteal phase. Gonadotrophin-releasing hormone agonist (GnRH-a) and progesterone supplementation in the luteal phase are some of the strategies that are widely used. In this chapter, we are solely focusing on strategies that can prevent OHSS in the luteal phase. This chapter concludes that apart from strategies to prevent OHSS development, if possible, individualized protocols should be adopted based on the patient’s needs and risk factors.