Severe OHSS - Yes, there is a strategy to prevent it!

Effective measures to prevent ovarian hyperstimulation syndrome (OHSS) rema in controversial, It became almost 'common knowledge' that there is no stra tegy that may completely prevent OHSS. Extensive clinical experience (albei t not derived from prospective randomized studies) clearly documents the ab ility of a single administration of gonadotrophin-releasing hormone (GnRH) agonist to effectively trigger ovulation, while completely eliminating any threat of clinically significant OHSS, This strategy cannot be used if the pituitary is down-regulated (as is the case in most assisted reproductive c ycles today), however, the newly-introduced GnRH antagonists open new oppor tunities for implementing this strategy, since the pituitary preserves its responsiveness to GnRH agonists, Combining GnRH antagonist-based ovarian st imulation (particularly in 'high responders'). with GnRH agonist-driven ovu lation triggering will make severe OHSS a disease of the past in assisted r eproduction.