OHSS Prevention IVF: Cochrane Review Overview
- Ovarian hyperstimulation syndrome (OHSS) poses a risk in assisted reproductive technology (ART) cycles, specifically in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI).
- OHSS arises from an excessive ovarian response to hormone medications during IVF, leading to enlarged ovaries and fluid shifts.
- The overview included 27 Cochrane ART reviews, focusing on OHSS in IVF or ICSI cycles.Reviews of intrauterine insemination and ovulation induction were excluded.
Combat OHSS risks in IVF cycles: This review of Cochrane studies pinpoints effective interventions. Discover how methods like metformin and GnRH antagonists substantially lower the chances of ovarian hyperstimulation syndrome (OHSS) in patients undergoing in vitro fertilization (IVF) and ICSI. The research also examines cutting-edge approaches, including “freeze-all” programs, offering new hope for those navigating assisted reproductive technology. News directory 3 delivers crucial findings, summarizing 27 Cochrane reviews to guide clinicians and inform policymakers. Find out which strategies are backed by strong evidence and which areas need further exploration. Discover what’s next for OHSS prevention in ART cycles.
Effective Interventions for OHSS Prevention and Treatment in ART Cycles
Updated June 7, 2025
Ovarian hyperstimulation syndrome (OHSS) poses a risk in assisted reproductive technology (ART) cycles, specifically in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). A new overview of Cochrane reviews examined interventions for preventing and treating moderate to severe OHSS in subfertile couples undergoing ART.
OHSS arises from an excessive ovarian response to hormone medications during IVF, leading to enlarged ovaries and fluid shifts. Mild OHSS affects 20% to 33% of cycles, while moderate or severe forms occur in 3% to 8%, possibly causing serious complications.Identifying effective treatment regimens to reduce OHSS incidence is crucial.
The overview included 27 Cochrane ART reviews, focusing on OHSS in IVF or ICSI cycles.Reviews of intrauterine insemination and ovulation induction were excluded. The evidence is current to December 12, 2016.
Seven reviews highlighted interventions that effectively reduced OHSS rates without negatively impacting pregnancy outcomes. one additional review was categorized as “promising.”
Moderate-quality evidence supports the use of several interventions to reduce OHSS rates in ART cycles:
- Metformin treatment before and during ART cycles in women wiht PCOS.
- Gonadotrophin-releasing hormone (GnRH) antagonist protocol in ART cycles.
- GnRH agonist (GnRHa) trigger in donor oocyte or “freeze-all” programs.
Low- or very low-quality evidence suggests the following interventions may also be beneficial:
- Clomiphene citrate for controlled ovarian stimulation in ART cycles.
- Cabergoline around the time of human chorionic gonadotrophin (hCG) governance or oocyte pickup in ART cycles.
- intravenous fluids (blood plasma expanders) around the time of hCG administration or egg pickup in ART cycles.
- Progesterone for luteal phase support in ART cycles.
Coasting (withholding gonadotrophins) shows promise but requires further research. current evidence is insufficient to broadly support freezing all embryos for later replacement.
What’s next
Clinicians can use this evidence to tailor treatment regimens, balancing OHSS reduction with maintaining pregnancy outcomes. However, the overview is limited by the lack of recent studies and updated reviews. Policymakers can use the findings to develop guidelines and identify areas for future research in ART cycles and OHSS prevention.