THE PATHOGENESIS OF OVARIAN HYPERSTIMULATION SYNDROME - A CONTINUING ENIGMA

Purpose: Our purpose was to review the available literature concerning the pathogenesis of ovarian hyperstimulation syndrome and, in light o f the most recent information, to attempt to provide further insight o n this iatrogenic complication associated with the induction of ovulat ion. Methods: Published studies related to this topic were identified through a computerized bibliographic search. Conclusions: The exact me chanism for the development of ovarian hyperstimulation syndrome is st ill obscure. It is well established that the syndrome is associated wi th the process of ovulation induced by either luteinizing hormone or h uman chorionic gonadotrophin. Following ovulation, one or more substan ces produced by the ovary are liberated in excess, increasing capillar y permeability resulting in the clinical features of the syndrome. It may well be that the syndrome is not triggered by a single mechanism b ut by the production and secretion of several substances acting in con cert, These may include prostaglandins, cytokines, the ovarian renin-a ngiotensin system, vascular endothelial growth factor; and nitric oxid e.