THE OVARIAN HYPERSTIMULATION SYNDROME

Techniques of assisted fertilization are usually preceded by ovarian s timulation therapies. This implies the risk of development of an ovari an hyperstimulation syndrome (OHS). With this article, clinical releva nce, possible pathogenetic mechanisms, diagnosis, therapy and preventi on of OHS are discussed. In addition, three patients with severe OHS a re presented. Valid parameters for OHS risk assessment are peripheral E2 values as well as number and diameter of follicles. Until now, the mechanisms which lead to severe OHS are unknown, but hCG seems to trig ger the development of symptoms, as OHS very rarely occurs without pri or hCG application. Symptoms of severe OHS comprise ovarian enlargemen t, fluid- and electrolyte imbalance, third space fluid accumulation, h aemoconcentration and hypercoagulation. Only symptomatic therapy is av ailable. The significance of vascular mediators for the development of OHS is discussed.