The prediction and management of ovarian hyperstimulation syndrome (OHSS) in assisted reproductive technology (ART) rely heavily on identifying key risk factors. Women with higher ovarian reserves, such as those with elevated anti-Müllerian hormone (AMH) levels and high antral follicle count (AFC), are at an increased risk of OHSS. Younger women and those with polycystic ovary syndrome (PCOS) are particularly susceptible due to heightened ovarian sensitivity to stimulation. Predictive models have been developed to assess the likelihood of OHSS based on these risk factors. As AMH and AFC are considered the most reliable indicators of ovarian response, they are currently often used to guide stimulation protocols. Studies show that using personalized protocols based on these markers can significantly reduce the risk of OHSS. The integration of advanced prediction models, including algorithms that consider estradiol levels and follicle count during stimulation, helps clinicians tailor treatment more effectively. By adjusting gonadotropin doses, employing alternative triggers like GnRH agonists, and utilizing strategies such as “freeze-all,” the risk of OHSS can be minimized. Continuous monitoring of patients throughout the cycle and early intervention based on predictive markers are essential to achieving safer outcomes in fertility treatments.