Treatment of ovarian hyperstimulation syndrome

Ovarian hyperstimulation syndrome (OHSS) is a rare complication of controlled ovarian hyperstimulation and ovulation induction that despite better preventative methods, continues to develop in some patients undergoing assisted reproduction. Patients with mild to moderate OHSS can be managed conservatively by reducing ascites and restoring intravascular volume. Patients with severe OHSS are always treated as inpatients and may require admission to the intensive care unit where they can also be treated for the complications of OHSS, such as DVTs. Several complications such as ovarian torsion, ectopic pregnancy and ovarian cyst are indication for laparoscopy, with laparotomy being required in cases such as hemorrhage of ruptured ovarian cyst. In some cases, when the patient is refractory to other treatments, therapeutic abortion may result in a significant improvement of the patient’s symptoms.