Severe OHSS is an iatrogenic, potentially life-threatening complication of
controlled ovarian hyperstimulation. Intravenous human albumin, administere
d around the time of oocyte retrieval has been claimed to prevent developme
nt of this serious event. It was hypothesized that albumin acts through its
osmotic pressure and through the binding and inactivation, at a critical t
ime of the cycle, of an hCG-mediated factor secreted by the corpora lutea,
that impedes capillary integrity and leads to the development of OHSS. The
present article evaluates the available evidence in the medical literature
whether albumin is effective in reducing the risk of severe OHSS. Several t
rials have been identified, most of them were retrospective and few were pr
ospective randomized controlled trials. Although albumin prophylaxis cannot
offer absolute protection, all three randomized placebo-controlled trials,
that have been published so far, demonstrated a significant reduction in t
he incidence of severe OHSS.