Guideline No. 315: Prevention of Ovarian Hyperstimulation Syndrome

Summary Statements1.The particular follicle-stimulating hormone formulation used for ovarian stimulation does not affect the incidence of hyperstimulation syndrome. (I)2.Coasting may reduce severe (III)3.Coasting longer than 3 days reduces in vitro fertilization pregnancy rates. (II-2)4.The use either luteinizing or human chorionic gonadotropin final oocyte maturation influence (I)5.There is no clear published evidence that lowering dose will result a decrease rate (III)6.Cabergoline starting from day syndrome patients at higher risk and appear to lower (II-2)7.Avoiding by freezing all embryos prevent prolonged high risk. (II-2)8.Pregnancy rates are affected when using gonadotropin-releasing (GnRH) agonists GnRH antagonist protocols egg frozen vitrification later transfer. (II-2)Recommendations1.The addition metformin should be considered with polycystic who undergoing because it (I-A)2.Gonadotropin dosing carefully individualized, taking into account patient’s age, body mass, antral follicle count, previous response gonadotropins. (II-3B)3.Cycle cancellation before administration gonadatropin an effective strategy prevention syndrome, but emotional financial burden imposes on cycle cancelled. (III-C)4.Gonadotropin-releasing recommended (OHSS). The OHSS have very robust can reduced agonist as substitute trigger maturation. (I-B)5.A protocol donor fertility preservation cycles. (III-C)6.Albumin other plasma expanders time retrieval (I-E)7.Elective single embryo transfer (III-C)8.Progesterone, rather gonadotropin, luteal phase support. (I-A)9.Outpatient culdocentesis disease progression (II-2B)