The Pathogenesis of the Ovarian Hyperstimulation Syndrome

The ovarian hyperstimulation syndrome is an iatrogenic complication of ovulation-induction therapy. In its most severe form, this syndrome involves massive ovarian enlargement and the formation of multiple ovarian cysts, fluid shifts resulting in extravascular fluid accumulation and intravascular volume depletion, renal failure, hypovolemic shock, and in some cases, death. The severe form is rare, with a reported incidence of 0.5 to 5 percent among patients undergoing ovulation-induction therapy. Ovulation-induction therapy is generally initiated with gonadotropins to stimulate follicle development and growth. The intensity of the ovarian hyperstimulation syndrome is related to the degree of ovarian follicular response. Estrogens, produced by . . .