[CG] Management of Ovarian Hyperstimulation Syndrome (OHSS)

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Abstract

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This procedure describes the general clinical procedures that need to be undertaken within the Assisted Conception Service (ACS), Glasgow Royal Infirmary (GRI).

OHSS is self-limiting and usually resolves spontaneously within several days. However, it may persist for longer particularly in those women receiving assisted conception treatment. Mild OHSS is common – it occurs in up to 33% of IVF treatment cycles. Moderate to severe OHSS is rare (occurs in 3 to 8% of IVF treatment cycles) but is life threatening. The clinical course is, however, a continuum of scope and severity.

Clinicians should be aware and women informed that pregnancies complicated by OHSS may be at increased risk of pre-eclampsia and preterm delivery. Those most at risk of suffering from OHSS are young women (<30 years of age) with a low BMI undergoing ovarian hyperstimulation treatment. Other predisposing factors include:

  • PCOS
  • The presence of multiple follicles/oocytes
  • Treatment with hCG (to mature oocytes during ovarian hyperstimulation)
  • Previous OHSS
  • Pregnancy

In all cases, the Assisted Conception Service team at GRI must be:

  • informed of the diagnosis using the proforma 
  • involved in clinical decisions and supervision of continuing care.

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Last reviewed: 01 March 2022

Next review: 31 March 2023

Author(s): Aparna Sastry

Version: 7

Approved By: H. Lyall, Assisted Conception Service, Glasgow Royal Infirmary

Document Id: C-SOP-056