Iatrogenic Ovarian Hyperstimulation Syndrome: Current Insights in to Therapeutic Advances

Ovarian Hyperstimulation Syndrome (OHSS) is an iatrogenic complication that arises due to an exaggerated ovarian response to exogenous gonadotropin administration, particularly during assisted reproductive techniques such as in vitro fertilization. Although most commonly associated with injectable gonadotropins, OHSS may also occur, albeit less frequently, with agents like clomiphene citrate or gonadotropin-releasing hormone analogues. Clinically, this manifests as abdominal distension, bloating, nausea, and ascites. In more severe presentations, patients may experience thromboembolic events, dyspnea due to pleural effusion, severe abdominal pain, hemoconcentration, dehydration, and intractable vomiting. A hallmark of OHSS is bilateral ovarian enlargement, with the degree of enlargement correlating with the severity of the syndrome. This review aims to explore the current evidence surrounding effective strategies for the prevention of ovarian hyperstimulation syndrome. Although a definitive method to completely eliminate the risk of OHSS has not yet been established, significant progress has been made by tailoring treatment protocols according to a patient’s individual risk profile. Stratifying women based on their susceptibility to OHSS has shown promise, particularly through the use of biomarkers such as Anti-Müllerian Hormone (AMH) levels and antral follicle count (AFC), which help predict ovarian response. Early identification and stratification of OHSS severity are critical in guiding management decisions, ranging from outpatient surveillance to inpatient care for moderate-to-critical cases