33391nas a2200217   45000080039000002450088000392100069001272600021001963000007002174900006002245203276400230653002032994653002333014653001333037653000833050653000933058653001533067100002133082700002133103856004933124       2003                          d00aReview of clinical course and treatment of ovarian hyperstimulation syndrome (OHSS)0 aReview of clinical course and treatment of ovarian hyperstimulat  cJanuary/February  a770 v93 aThe ovarian hyperstimulation syndrome (OHSS) is a rare iatrogenic complication of ovarian stimulation occurring during the luteal phase or during early pregnancy. This complication is unusual as it is not the consequence of a treatment which is vital or mandatory for the patient's health. Nevertheless, it can be accompanied by severe morbidity and may even be fatal. Data pertaining to the clinical course and consequences of OHSS in women and its treatment were searched using Medline, Current Contents and PubMed. To date, only a few studies have collected a large number of cases of OHSS. The clinical course of OHSS may involve, according to its severity and the occurrence of pregnancy, electrolytic imbalance, neurohormonal and haemodynamic changes, pulmonary manifestations, liver dysfunction, hypoglobulinaemia, febrile morbidity, thromboembolic phenomena, neurological manifestations and adnexal torsion. Treatment of the acute phase relies only on an empirical and symptomatic approach. The general approach will be adapted to the levels of severity. Specific approaches such as paracentesis, pleural puncture, surgical approach of OHSS and specific medication during OHSS were evaluated sporadically. More adequate treatment methods would require a better understanding of the underlying pathophysiological mechanisms, to promote an aetiological therapeutic approach. Properly conducted studies, including large numbers of patients are required in order to determine the best method of prevention and management. (C) Copyright Oxford University Press 2003.; References: Aboulghar, M.A., Mansour, R.T., Serour, G.I. and Amin, Y. (1990) Ultrasonically guided vaginal aspiration of ascites in the treatment of severe ovarian hyperstimulation syndrome. Fertil. Steril., 53, 933-935. Aboulghar, M.A., Mansour, R.T., Serour, G.I., Riad, R. and Ramzi, A.M. (1992) Autotransfusion of the ascitic fluid in the treatment of severe ovarian hyperstimulation syndrome. Fertil. Steril., 58, 1056-1059. Aboulghar, M.A., Mansour, R.T., Serour, G.I., Sattar, M.A., Amin, Y.M. and Elattar, I. (1993) Management of severe ovarian hyperstimulation syndrome by ascitic fluid aspiration and intensive intravenous fluid therapy. Obstet. Gynecol., 81, 108-111. Aboulghar, M.A., Mansour, R.T., Serour, G.I., and Amin, Y.M. (1998) Moderate ovarian hyperstimulation syndrome complicated by deep cerebrovascular thrombosis. Hum. Reprod., 13, 2088-2091. Abramov, Y., Elchalal, U. and Schenker, J.G. (1998a) Febrile morbidity in severe and critical ovarian hyperstimulation syndrome: a multicentre study. Hum. Reprod., 13, 3128-3131. Abramov, Y., Elchalal, U. and Schenker, J.G. (1998b) Obstetric outcome of in vitro fertilized pregnancies complicated by severe ovarian hyperstimulation syndrome: a multicenter study. Fertil. Steril., 70, 1070-1076. Abramov, Y., Elchalal, U. and Schenker, J.G. (1999a) Pulmonary manifestations of severe ovarian hyperstimulation syndrome: a multicenter study. Fertil. Steril., 71, 645-651. Abramov, Y., Naparstek, Y., Elchalal, U., Lewin, A., Schechter, E. and Schenker, J.G. (1999b) Plasma immunoglobulins in patients with severe ovarian hyperstimulation syndrome. Fertil. Steril., 71, 102-105. Abramov, Y., Fatum, M., Abrahamov, D. and Schenker, J.G. (2001) Hydroxyethylstarch versus human albumin for the treatment of severe ovarian hyperstimulation syndrome: a preliminary report. Fertil. Steril., 75, 1228-1230. Abu-Louz, S.K., Ahmed, A.A. and Swan, R.W. (1997) Spontaneous ovarian hyperstimulation syndrome with pregnancy. Am. J. Obstet. Gynecol., 177, 476-477. Adlercreutz, H. and Tenhunen, R. (1970) Some aspects of the interaction between natural and synthetic female sex hormones and the liver. Am. J. Med., 49, 630. Akdemir, R., Uyan, C. and Emiroglu, Y. (2002) Acute myocardial infarction secondary thrombosis associated with ovarian hyperstimulation syndrome. Int. J. Cardiol., 83, 187-189. Aune, B., Hoie, K.E., Oian, P., Holst, N. and Osterud, B. (1991) Does ovarian stimulation for in-vitro fertilization induce a hypercoagulable state? Hum. Reprod., 6, 925-927. Aurousseau, M.H., Samama, M.M., Belhassen, A., Herve, F. and Hugues, J.N. (1995) Risk of thromboembolism in relation to an in-vitro fertilization programme: three case reports. Hum. Reprod., 10, 94-97. Ayhan, A., Urman, B., Gurgan, T., Tuncer, Z.S. and Deren, O. (1993) Thrombosis of the internal jugular vein associated with severe ovarian hyperstimulation syndrome. Aust. N. Z. J. Obstet. Gynaecol., 33, 436-437. Ayhan, A., Tuncer, Z.S. and Aksu, A.T. (1996) Ovarian hyperstimulation syndrome associated with spontaneous pregnancy. Hum. Reprod., 11, 1600-1601. Bachmeyer, C., Grateau, G., Bruel, D. and Sereni, D. (1994) Thrombosis of the internal jugular vein in ovarian hyperstimulation syndrome. Rev. Med. Interne, 15, 52-54. Balasch, J., Carmona, F., Llach, J., Arroyo, V., Jove, I. and Vanrell, J.A. (1990) Acute prerenal failure and liver dysfunction in a patient with severe ovarian hyperstimulation syndrome. Hum. Reprod., 5, 348-351. Balasch, J., Arroyo, V., Carmona, F., Llach, J., Jimenez, W., Pare, J.C. and Vanrell, J.A. (1991) Severe ovarian hyperstimulation syndrome: role of peripheral vasodilation. Fertil. Steril., 56, 1077-1083. Balasch, J., Arroyo, V., Fabregues, F., Salo, J., Jimenez, W., Pare, J.C. and Vanrell, J.A. (1994) Neurohormonal and hemodynamic changes in severe cases of the ovarian hyperstimulation syndrome. Ann. Intern. Med., 121, 27-33. Balasch, J., Reverter, J.C., Fabregues, F., Tassies, D., Ordinas, A. and Vanrell, J.A. (1996) Increased induced monocyte tissue factor expression by plasma from patients with severe ovarian hyperstimulation syndrome. Fertil. Steril., 66, 608-613. Balen, A.H. and Jacobs, H.S. (1991) Gonadotrophin surge attenuating factor: a missing link in the control of LH secretion? Clin. Endocrinol., 35, 399-402. Bar-Hava, I. and Homburg, R. (1993) Correct timing of administration of diuretic agents for the treatment of ovarian hyperstimulation syndrome. Gynecol. Endocrinol., 7, 63-65. Bassil, S., Da Costa, S., Toussaint-Demylle, D., Lambert, M., Gordts, S. and Donnez, J. (1996) A unilateral hydrothorax as the only manifestation of ovarian hyperstimulation syndrome: a case report. Fertil. Steril., 66, 1023-1025. Beck, D.H., Massey, S., Taylor, B.L. and Smith, G.B. (1995) Continuous ascitic recirculation in severe ovarian hyperstimulation syndrome. Intensive Care Med., 21, 590-593. Beerendonk, C.C., van Dop, P.A., Braat, D.D. and Merkus, J.M. (1998) Ovarian hyperstimulation syndrome: facts and fallacies. Obstet. Gynecol. Surv., 53, 439-449. Belaen, B., Geerinckx, K., Vergauwe, P. and Thys, J. (2001) Internal jugular vein thrombosis after ovarian stimulation. Hum. Reprod., 16, 510-512. Benifla, J.L., Conard, J., Naouri, M., Darai, E., Bascou, V., Neuraz, A., Deval, B., Guglielmina, J.N., Crequat, J. and Madelenat, P. (1994) Ovarian hyperstimulation syndrome and thrombosis. Apropos of a case of thrombosis of the internal jugular vein. Review of the literature. J. Gynecol. Obstet. Biol. Reprod. (Paris), 23, 778-783. Benshushan, A., Shushan, A., Paltiel, O., Mordel, N. and Laufer, N. (1995) Ovulation induction with clomiphene citrate complicated by deep vein thrombosis. Eur. J. Obstet. Gynecol. Reprod. Biol., 62, 261-262. Borenstein, R., Elhalah, U., Lunenfeld, B. and Schwartz, Z.S. (1989) Severe ovarian hyperstimulation syndrome: a reevaluated therapeutic approach. Fertil. Steril., 51, 791-795. Borgaonkar, M. and Marshall, J. (1999) Marked elevation of serum transaminases may be associated with ovarian hyperstimulation syndrome. Am. J. Gastroenterol., 94, 3373-3374. Boulieu, D., Ninet, J., Pinede, L., Didier-Laurent, J.F. and Franco, A. (1989) Thrombose veineuse precoce de siege inhabituel en debut de grossesse apres hyperstimulation ovarienne. Contracept. Fertil. Sex., 17, 725-727. Brinsden, P.R., Wada, I., Tan, S.L., Balen, A. and Jacobs, H.S. (1995) Diagnosis, prevention and management of ovarian hyperstimulation syndrome. Br. J. Obstet. Gynaecol., 102, 767-772. Brown, T., Anand, A., Ritchie, L.D., Clewley, J.P. and Reid, T.M. (1984) Intrauterine parvovirus infection associated with hydrops fetalis. Lancet, 3, 1033-1034. Campo, S., Bezzi, I. and Garcea, N. (2000) Ovarian hyperstimulation after administration of triptorelin therapy to a patient with polycystic ovary syndrome. Fertil. Steril., 73, 1256-1258. Caspi, E., Ronen, J., Schreyer, P. and Goldberg, M.D. (1976) The outcome of pregnancy after gonadotrophin therapy. Br. J. Obstet. Gynaecol., 83, 967-973. Chen, C.D., Wu, M.Y., Yang, J.H., Chen, S.U., Ho, H.N. and Yang, Y.S. (1997) Intravenous albumin does not prevent the development of severe ovarian hyperstimulation syndrome. Fertil. Steril., 68, 287-291. Chen, C.D., Yang, J.H., Chao, K.H., Chen, S.U., Ho, H.N. and Yang, Y.S. (1998) Effects of repeated abdominal paracentesis on uterine and intraovarian haemodynamics and pregnancy outcome in severe ovarian hyperstimulation syndrome. Hum. Reprod., 13, 2077-2081. Chen, C.D., Wu, M.Y., Chen, H.F., Chen, S.U., Ho, H.N. and Yang, Y.S. (2000) Relationships of serum pro-inflammatory cytokines and vascular endothelial growth factor with liver dysfunction in severe ovarian hyperstimulation syndrome. Hum. Reprod., 15, 66-71. Chen, G., Wilson, R., Wang, S.H., Zheng, H.Z., Walker, J.J. and McKillop, J.H. (1996) Tumour necrosis factor-alpha (TNF-alpha) gene polymorphism and expression in pre-eclampsia. Clin. Exp. Immunol., 104, 154-159. Choktanasiri, W. and Rojanasakul, A. (1995) Acute arterial thrombosis after gamete intrafallopian transfer: a case report. J. Assist. Reprod. Genet., 12, 335-337. Cil, T., Tummon, I.S., House, A.A., Taylor, B., Hooker, G., Franklin, J., Rankin, R. and Carey, M. (2000) A tale of two syndromes: ovarian hyperstimulation and abdominal compartment. Hum. Reprod., 15, 1058-1560. Cluroe, A.D. and Synek, B.J. (1995) A fatal case of ovarian hyperstimulation syndrome with cerebral infarction. Pathology, 27, 344-346. Coccia, M.E., Bracco, G.L., Cattaneo, A. and Scarselli, G. (1995) Massive vulvar edema in ovarian hyperstimulation syndrome. A case report. J. Reprod. Med., 40, 659-660. Cremisi, H.D. and Mitch, W.E. (1994) Profound hypotension and sodium retention with the ovarian hyperstimulation syndrome. Am. J. Kidney Dis., 24, 854-859. Crooke, A.C., Butt, W.R., Carrington, S.P., Morris, R., Palmer, R.F. and Logan Edwards, R. (1964) Pregnancy in women with secondary amenorrhoea treated with human gonadotrophins. Lancet, January, 184-188. Dalrymple, J.C., Smith, D.H., Sinosich, M.J. and Saunders, D.M. (1983) Venous thrombosis with high estradiol levels following gonadotropin therapy. Infertility, 5, 239-245. Daniel, Y., Yaron, Y., Oren, M., Peyser, M.R. and Lessing, J.B. (1995) Ovarian hyperstimulation syndrome manifests as acute unilateral hydrothorax. Hum. Reprod., 10, 1684-1685. Davies, A.J. and Patel, B. (1999) Hyperstimulation-brain attack. Br. J. Radiol., 72, 923-924. Davis, E. and Hellebaum, AA. (1944) Observations on the experimental use of gonadotropic extracts in the human female. J. Clin. Endocrinol., 4, 400-409. Delvigne, A. and Rozenberg, S. (2002) Epidemiology and prevention of ovarian hyperstimulation syndrome (OHSS): a review. Hum. Reprod. Update, 8, 559-578. Delvigne, A., Demoulin, A., Smitz, J., Donnez, J., Koninckx, P., Dhont, M., Englert, Y., Delbeke, L., Darcis, L., Gordts, S., Puttemans, P., Gerris, J., Schoysman, R. and Leroy, F. (1993). The ovarian hyperstimulation syndrome in in-vitro fertilization: a Belgian multicentric study. I. Clinical and biological features. Hum. Reprod, 8, 1353-1360. Delvigne, A., Kostyla, K., De Leener, A., Lejeune, B., Cantiniaux, B., Bergmann, P. and Rozenberg, S. (2002) Metabolic characteristics of OHSS patients who developed ovarian hyperstimulation syndrome. Hum. Reprod., 17, 1994-1996. Di Carlo, C., Bruno, P., Cirillo, D., Morgera, R., Pellicano, M. and Nappi, C. (1997) Increased concentrations of renin, aldosterone and Ca125 in a case of spontaneous, recurrent, familial, severe ovarian hyperstimulation syndrome. Hum. Reprod., 12, 2115-2117. Dulitzky, M., Cohen, S.B., Inbal, A., Seidman, D.S., Soriano, D., Lidor, A., Mashiach, S. and Rabinovici, J. Increased prevalence of thrombophilia among women with severe ovarian hyperstimulation syndrome. Fertil. Steril., 77, 463-467. Dumont, M., Combet, A. and Domenichini, Y. (1980) [Cerebral arterial thrombosis following ovarian hyperstimulation and sextuple pregnancy. Therapeutic abortion]. Nouv. Presse Med., 13, 3628-3629. Editorial (1991) Ovarian hyperstimulation syndrome. Lancet, 338, 1111-1112. el Kouri, D., Bani-Sadr, F., De Faucal, P., Hamidou, M., Ripoll, P. and Planchon, B. (1995) [Jugular thrombosis after ovarian hyperstimulation: an avoidable complication?]. Presse Med., 24, 547. Ellis, M.H., Nun, I.B., Rathaus, V., Werner, M. and Shenkman, L. (1998) Internal jugular vein thrombosis in patients with ovarian hyperstimulation syndrome. Fertil. Steril., 69, 140-142. El Sadek, M.M., Amer, M.K. and Fahmy, M. (1998) Acute cerebrovascular accidents with severe ovarian hyperstimulation syndrome. Hum. Reprod., 13, 1793-1795. Engel, T., Jewelewicz, R., Dyrenfurth, I., Speroff, L. and Van de Wiele, R.L. (1972) Ovarian hyperstimulation syndrome. Report of a case with notes on pathogenesis and treatment. Am. J. Obstet. Gynecol., 112, 1052-1060. Engmann, L., Maconochie, N., Sladkevicius, P., Bekir, J., Campbell, S. and Tan, S.L. (1999) The outcome of in-vitro fertilization treatment in women with sonographic evidence of polycystic ovarian morphology. Hum. Reprod., 14, 167-171. Enskog, A., Henriksson, M., Unander, M., Nilsson, L. and Brannstrom, M. (1999) Prospective study of the clinical and laboratory parameters of patients in whom ovarian hyperstimulation syndrome developed during controlled ovarian hyperstimulation for in vitro fertilization. Fertil. Steril., 71, 808-814. Esteban-Altirriba, J. (1961) Le syndrome d'hyperstimulation massive des ovaries. Rev. Francaise de Gynecologie et d'Obstetrique, 7-8, 555-564. Evbuomwan, I.O., Davison, J.M. and Murdoch, A.P. (2000) Coexistent hemoconcentration and hypoosmolality during superovulation and in severe ovarian hyperstimulation syndrome: a volume homeostasis paradox. Fertil. Steril., 74, 67-72. Fabregues, F., Balasch, J., Manau, D., Jimenez, W., Arroyo, V., Creus, M., Rivera, F. and Vanrell, J.A. (1998) Haematocrit, leukocyte and platelet counts and the severity of the ovarian hyperstimulation syndrome. Hum. Reprod., 13, 2406-2410. Fabregues, F., Balasch, J., Gines, P., Manau, D., Jimenez, W., Arroyo, V., Creus, M. and Vanrell, J.A (1999). Ascites and liver test abnormalities during severe ovarian hyperstimulation syndrome. Am. J. Gastroenterol., 94, 994-999. Fakih, H. and Bello, S. (1992) Ovarian cyst aspiration: a therapeutic approach to ovarian hyperstimulation syndrome. Fertil. Steril., 58, 829-832. Ferraretti, A.P., Gianaroli, L., Diotallevi, L., Festi, C. and Trounson, A. (1992) Dopamine treatment for severe ovarian hyperstimulation syndrome. Hum. Reprod., 7, 180-183. Figueroa-Casas, P. (1958) Reaccion ovariaa monstruosa a las gonadotropines a proposito de un caso fatal. Ann. Cirug., 23, 116-118. Fluker, M.R., Copeland, J.E. and Yuzpe, A.A. (2000) An ounce of prevention: outpatient management of the ovarian hyperstimulation syndrome. Fertil. Steril., 73, 821-824. Forman, R.G., Frydman, R., Egan, D., Ross, C. and Barlow, D.H. (1990) Severe ovarian hyperstimulation syndrome using agonists of gonadotropin-releasing hormone for in vitro fertilization: a European series and a proposal for prevention. Fertil. Steril., 53, 502-509. Fournet, N., Surrey, E. and Kerin, J. (1991) Internal jugular vein thrombosis after ovulation induction with gonadotropins. Fertil. Steril., 56, 354-356. Fowler, P.A., Sorsa, T., Harris, W.J., Knight, P.G. and Mason, H.D. (2001) Relationship between follicle size and gonadotrophin surge attenuating factor (GnSAF) bioactivity during spontaneous cycles in women. Hum. Reprod., 16, 1353-1358. Friedler, S., Rachstein, A., Bukovsky, I., Ron-El, R. and Raziel, A. (1998) Unilateral hydrothorax as a sole and recurrent manifestation of ovarian hyperstimulation syndrome following in-vitro fertilization. Hum. Reprod., 13, 859-861. Fukaya, T., Chida, S., Terada, Y., Funayama, Y. and Yajima, A. (1994) Treatment of severe ovarian hyperstimulation syndrome by ultrafiltration and reinfusion of ascitic fluid. Fertil. Steril., 61, 561-564. Gamzu, R., Almog, B., Levin, Y., Avni, A., Lessing, J.B. and Baram, A. (2002) Efficacy of hydroxyethyl starch and Haemaccel for the treatment of severe ovarian hyperstimulation syndrome. Fertil. Steril., 77, 1302-1303. Gergely, R.Z., Paldi, E., Erlik, Y. and Makler, A. (1976) Treatment of ovarian hyperstimulation syndrome by antihistamine. Obstet. Gynecol., 47, 83-85. Germond, M., Wirthner, D., Thorin, D., Ruchat, P., Essinger, A. and De Grandi, P. (1996) Aorto-subclavian thromboembolism: a rare complication associated with moderate ovarian hyperstimulation syndrome. Hum. Reprod., 11, 1173-1176. Gidley-Baird, A.A., O'Neill, C., Sinosich, M.J., Porter, R.N., Pike, I.L. and Saunders, D.M. (1986) Failure of implantation in human in vitro fertilization and embryo transfer patients: the effects of altered progesterone/estrogen ratios in humans and mice. Fertil. Steril., 45, 69-74. Gines, P., Arroyo, V., Vargas, V., Planas, R., Casafont, F., Panes, J., Hoyos, M., Viladomiu, L., Rimola, A., Morillas, R. et al. (1991) Paracentesis with intravenous infusion of albumin as compared with peritoneovenous shunting in cirrhosis with refractory ascites. N. Engl. J. Med., 325, 829-835. Golan, A., Ron-el, R., Herman, A., Soffer, Y., Weinraub, Z. and Caspi, E. (1989) Ovarian hyperstimulation syndrome: an update review. Obstet. Gynecol. Surv., 44, 430-440. Gregory, W.T. and Patton, P.E. (1999) Isolated pleural effusion in severe ovarian hyperstimulation: a case report. Am. J. Obstet. Gynecol., 180, 1468-1471. Hampton, H.L., Whitworth, N.S. and Cowan, B.D. (1991) Gonadotrophin-releasing hormone agonist (leuprolide acetate) induced ovarian hyperstimulation syndrome in a woman undergoing intermittent hemodialysis. Fertil. Steril., 55, 429-431. Haning, R.V., Jr, Strawn, E.Y. and Nolten, W.E. (1985) Pathophysiology of the ovarian hyperstimulation syndrome. Obstet. Gynecol., 66, 220-224. Hee-Dong, C., Eun-Joo, P., Sung-Hoon, K., Chung-Hoon, K., Byung-Moon, K. and Yoo Seok, C. (2001) Ovarian hyperstimulation complicating a spontaneous singleton pregnancy: case report. J. Assist. Reprod. Genet., 18, 120-123. Heinig, J., Behre, H.M. and Klockenbusch, W. (2001) Occlusion of the ulnar artery in a patient with severe ovarian hyperstimulation syndrome. Eur. J. Obstet. Gynecol. Reprod. Biol., 96, 126-127. Hignett, M., Spence, J.E. and Claman, P. (1995) Internal jugular vein thrombosis: a late complication of ovarian hyperstimulation syndrome despite mini-dose heparin prophylaxis. Hum. Reprod., 10, 3121-3123. Hock, D.L., Huhn, R.D. and Kemmann, E. (1997) Leukocytosis in response to exogenous gonadotrophin stimulation. Hum. Reprod., 12, 2143-2146. Hocke, C., Guyon, F., Dulucq, M.C., Grenier, N., Papaxanthos, A. and Leng, J.J. (1995) Thromboembolism and ovarian hyperstimulation. J. Gynecol. Obstet. Biol. Reprod. (Paris), 24, 691-696. Hollemaert, S., Wautrecht, J.C., Capel, P., Abramowicz, M.J., Englert, Y. and Delbaere, A. (1996) Thrombosis associated with ovarian hyperstimulation syndrome in a carrier of the factor V Leiden mutation. Thromb. Haemost., 76, 275-277. Horstkamp, B., Lubke, M., Kentenich, H., Riess, H., Buscher, U. and Lichtenegger, W. (1994) Internal jugular vein thrombosis caused by resistance to activated protein C as a complication of ovarian hyperstimulation after in-vitro fertilization. Hum. Reprod., 11, 280-282. Hsieh, M.J., Tsao, T.C. and Cheng, P.J. (1994) Ovarian hyperstimulation syndrome with minimal ascites and massive pleural effusion: report of a case. J. Formos. Med. Assoc., 93, 882-884. Hulinsky, I. and Smith, H.C. (1995) External jugular vein thrombosis: a complication of the ovarian hyperstimulation syndrome. Med. J. Aust., 162, 335-336. Humbert, G., Delaunay, P., Leroy, J., Robert, M., Schuhl, J.F., Poussin, A. and Augustin, P. (1973) [Cerebrovascular accident during treatment with gonadotropins]. Nouv. Presse Med., 2, 28-30. Huong, D.L., Wechsler, B., Piette, J.C., Arfi, S., Gallinari, C., Darbois, Y., Frances, C. and Godeau, P. (1996) Risks of ovulation-induction therapy in systemic lupus erythematosus. Br. J. Rheumatol., 35, 1184-1186. Hwang, W.J., Lai, M.L., Hsu, C.C. and Hou, N.T. (1998) Ischemic stroke in a young woman with ovarian hyperstimulation syndrome. J. Formos. Med. Assoc., 97, 503-506. Inbar, O.J., Levran, D., Mashiach, S. and Dor, J. (1994) Ischemic stroke due to induction of ovulation with clomiphene citrate and menotropins without evidence of ovarian hyperstimulation syndrome. Fertil. Steril., 62, 1075-1076. Insler, V. and Lunenfeld, B. (1997) Pathogenesis of ovarian hyperstimulation syndrome. In: V. Gomel and P.C.K. Leung (eds), In-Vitro Fertilization and Assisted Reproduction. Monduzzi Editore, Bologna, pp. 433-439. Ito, M., Harada, T., Iwabe, T., Tanikawa, M. and Terakawa, N. (2000) Cytokine levels in a patient with severe ovarian hyperstimulation syndrome before and after the ultrafiltration and reinfusion of ascitic fluid. J. Assist. Reprod. Genet., 17, 118-120. Jacob, S., Byrne, P. and Harrison, RF. (1999) Symptomatic cystic swelling at the root of the neck with left sided pleural effusion as a presentation of ovarian hyperstimulation syndrome. Br. J. Obstet. Gynaecol., 106, 986-988. Jahier, J., Malbranche-Aupecle, M.H., Feldman, J.P., Kamp, A., Mavel, A., Barthelet, J. and Halfon, D. (1985) [Ovarian hyperstimulation: treatment of voluminous cysts by percelioscopic puncture]. Rev. Francaise Gynecol. Obstet., 80, 109-111. Jewelewicz, R. and Vande Wiele, R.L. (1975) Acute hydrothorax as the only symptom of ovarian hyperstimulation syndrome. Am. J. Obstet. Gynecol., 121, 1121. Jiva, T.M. and Israel, R.H. (1993) Ovarian hyperstimulation presenting as acute hydrothorax in early intrauterine pregnancy. Chest, 103, 1924-1925. Jung, B.G. and Kim, H. (2001) Severe spontaneous ovarian hyperstimulation syndrome with MR findings. J. Comput. Assist. Tomogr., 25, 215-217. Kaaja, R., Siegberg, R., Tiitinen, A. and Koskimies, A. (1989) Severe ovarian hyperstimulation syndrome and deep venous thrombosis. Lancet, 2, 1043. Katz, Z., Lancet, M., Borenstein, R. and Chemke, J. (1984) Absence of teratogenicity of indomethacin in ovarian hyperstimulation syndrome. Int. J. Fertil., 29, 186-188. Kermode, A.G., Churchyard, A. and Carroll, W.M. (1992) Stroke complicating severe ovarian hyperstimulation syndrome. Aust. N. Z. J. Med., 23, 219-220. Khalaf, Y., Anderson, H., Taylor, A. and Braude, P. (2000) Two rare events in one patient undergoing assisted conception: empty follicle syndrome and ovarian hyperstimulation with the sole administration of a gonadotropin-releasing hormone agonist. Fertil. Steril., 73, 171-172. Kim, H.C., Kemmann, E., Shelden, R.M. and Saidi, P. (1981) Response of blood coagulation parameters to elevated endogenous 17 beta-estradiol levels induced by human menopausal gonadotropins. Am. J. Obstet. Gynecol., 140, 807-810. Kingsland, C.R., Collins, J.V., Rizk, B. and Mason, B.A. (1989) Ovarian hyperstimulation presenting as acute hydrothorax after in vitro fertilization. Am. J. Obstet. Gynecol., 161, 381-382. Kirshon, B., Doody, M.C., Cotton, D.B. and Gibbons, W. (1988) Management of ovarian hyperstimulation syndrome with chlorpheniramine maleate, mannitol, and invasive hemodynamic monitoring. Obstet. Gynecol., 71, 485-487. Kissler, S., Neidhardt, B., Siebzehnrubl, E., Schmitt, H., Tschaikowsky, K. and Wildt, L. (2001) The detrimental role of colloidal volume substitutes in severe ovarian hyperstimulation syndrome: a case report. Eur. J. Obstet. Gynecol. Reprod. Biol., 99, 131-134. Kligman, I., Noyes, N., Benadiva, C.A. and Rosenwaks, Z. (1995) Massive deep vein thrombosis in a patient with antithrombin III deficiency undergoing ovarian stimulation for in vitro fertilization. Fertil. Steril., 63, 673-676. Knox, G.E. (1974) Antihistamine blockade of the ovarian hyperstimulation syndrome. Am. J. Obstet. Gynecol., 118, 992-994. Kodama, H., Fukuda, J., Karube, H., Matsui, T., Shimizu, Y. and Tanaka, T. (1995) Characteristics of blood hemostatic markers in a patient with ovarian hyperstimulation syndrome who actually developed thromboembolism. Fertil. Steril., 64, 1207-1209. Kodama, H., Fukuda, J., Karube, H., Matsui, T., Shimizu, Y. and Tanaka, T. (1996) Status of the coagulation and fibrinolytic systems in ovarian hyperstimulation syndrome. Fertil. Steril., 66, 417-424. Koike, T., Araki, S., Minakami, H., Ogawa, S., Sayama, M., Shibahara, H. and Sato, I. (2000) Clinical efficacy of peritoneovenous shunting for the treatment of severe ovarian hyperstimulation syndrome. Hum. Reprod., 15, 113-117. Lamon, D., Chang, C.K., Hruska, L., Kerlakian, G. and Smith, J.M. (2000) Superior vena cava thrombosis after in vitro fertilization: case report and review of the literature. Ann. Vasc. Surg., 14, 283-285. Le Dall, R. (1957) Le syndrome d'hyperluteinisation massive des deux ovaires par injection intempestive d'hormones gonadotropes. These Paris, no. 915. Lesny, P., Maguiness, S.D., Hay, D.M., Robinson, J., Clarke, C.E. and Killick, S.R. (1999) Ovarian hyperstimulation syndrome and benign intracranial hypertension in pregnancy after in-vitro fertilization and embryo transfer: case report. Hum. Reprod., 14, 1953-1935. Letterie, G.S. (2000) Ovarian hyperstimulation caused by a gonadotropin agonist. Am. J. Obstet. Gynecol., 182, 747. Levin, I., Almog, B., Avni, A., Baram, A., Lessing, J.B. and Gamzu, R. (2002) Effect of paracentesis of ascitic fluids on urinary output and blood indices in patients with severe ovarian hyperstimulation syndrome. Fertil. Steril., 77, 986-988. Levin, M.F., Kaplan, B.R. and Hutton, L.C. (1995) Thoracic manifestations of ovarian hyperstimulation syndrome. Can. Assoc. Radiol. J., 46, 23-26. Lincoln, S., Opsahl, M.S., Blauer, K., Black, S. and Schulman, J. (2002) Aggressive outpatient treatment of ovarian hyperstimulation syndrome with ascites using transvaginal culdocentesis and intravenous albumin minimizes hospitalization. J. Assist. Reprod. Genet., 19, 159-163. Lipitz, S., Ben-Rafael, Z., Bider, D., Shalev, J. and Mashiach, S. (1991) Quintuplet pregnancy and third degree ovarian hyperstimulation despite withholding human chorionic gonadotrophin. Hum. Reprod., 6, 1478-1479. Lipitz, S., Grisaru, D., Achiron, R., Ben-Baruch, G., Schiff, E. and Mashiach, S. (1996) Spontaneous ovarian hyperstimulation mimicking an ovarian tumour. Hum. Reprod., 11, 720-721. Loret de Mola, J.R. (1999) Pathophysiology of unilateral pleural effusions in the ovarian hyperstimulation syndrome. Hum. Reprod., 14, 272-273. Loret de Mola, J.R., Kiwi, R., Austin, C. and Goldfarb, J.M. (2002) Subclavian deep vein thrombosis associated with the use of recombinant folliclestimulating hormone (Gonal-F) complicating mild ovarian hyperstimulation syndrome. Fertil. Steril., 73, 1253-1256. Ludwig, M., Tolg, R., Richardt, G., Katus, H.A. and Diedrich, K. (1999) Myocardial infarction associated with ovarian hyperstimulation syndrome. JAMA, 282, 632-633. Ludwig, M., Felberbaum, R.E. and Diedrich, K. (2000) Deep vein thrombosis during administration of HMG for ovarian stimulation. Arch. Gynecol. Obstet., 263, 139-141. Luxman, D., Cohen, J.R., Gordon, D., Wolman, I., Wolf, Y. and David, M.P. (1996) Unilateral vulvar edema associated with paracentesis in patients with severe ovarian hyperstimulation syndrome. A report of nine cases. J. Reprod. Med., 41, 771-774. MacDougall, M.J., Tan, S.L. and Jacobs, H.S. (1992) In-vitro fertilization and the ovarian hyperstimulation syndrome. Hum. Reprod., 7, 597-600. Makhmakhi, S. (1989) Thromboses veineuses profondes compliquant les grossesses induites. A propos de 7 observations. These de Medecine Lyon, No. 414. Man, A., Schwarz, Y. and Greif, J. (1997) Pleural effusion as a presenting symptom of ovarian hyperstimulation syndrome. Eur. Respir. J., 10, 2425-2426. Manaka, T., Akahori, A., Araki, S. and Tamada, T. (1991) Changes in coagulability and fibrinolytic activity in the patients with ovarian hyperstimulation syndrome. Nippon Sankal Fujinka Gakkai Zassi, 43, 1653-1659. Mancini, A., Milardi, D., Di Pietro, M.L., Giacchi, E., Spagnolo, A.G., Di Donna, V., De Marinis, L. and Jensen, L. (2001) A case of forearm amputation after ovarian stimulation for in vitro fertilization-embryo transfer. Fertil. Steril., 76, 198-200. Mashiach, S., Bider, D., Moran, O., Goldenberg, M. and Ben-Rafael, Z. (1990) Adnexal torsion of hyperstimulated ovaries in pregnancies after gonadotropin therapy. Fertil. Steril., 53, 76-80. Mathur, R. and Jenkins, J. (2000a) Selection of appropriate controls for outcome study of IVF pregnancies associated with ovarian hyperstimulation syndrome. Fertil. Steril., 73, 181-182. Mathur, R. and Jenkins, J. (2000b) Is ovarian hyperstimulation syndrome associated with a poor obstetric outcome? Br. J. Obstet. Gynaecol., 107, 943-946. Meldrum, D.R. (1990) Oocyte donation. Curr. Opin. Obstet. Gynecol., 2, 718-720. Midgley, D.Y., Khalaf, Y., Braude, P.R. and Nelson-Piercy, C. (1999) Recurrent cholestasis following ovarian hyperstimulation syndrome: case report. Hum. Reprod., 14, 2249-2251. Mills, M.S., Eddowes, H.A., Fox, R. and Wardle, P.G. (1992) Subclavian vein thrombosis: a late complication of ovarian hyperstimulation syndrome. Hum. Reprod., 7, 370-371. Moosburger, D. and Tews, G. (1996) Severe ovarian hyperstimulation syndrome and combined intrauterine and tubal pregnancy after in-vitro fertilization and embryo transfer. Hum. Reprod., 11, 68-69. Morris, R.S. and Paulson, R.J. (1999) Increased angiotensin-converting enzyme activity in a patient with severe ovarian hyperstimulation syndrome. Fertil. Steril., 71, 562-563. Morris, R.S., Miller, C., Jacobs, L. and Miller, K. (1995a) Conservative management of ovarian hyperstimulation syndrome. J. Reprod. Med., 40, 711-714. Morris, R.S., Wong, I.L., Kirkman, E., Gentschein, E. and Paulson, R.J. (1995b) Inhibition of ovarian-derived prorenin to angiotensin cascade in the treatment of ovarian hyperstimulation syndrome. Hum. Reprod., 10, 1355-1358. Moutos, D.M., Miller, M.M. and Mahadevan, M.M. (1997) Bilateral internal jugular venous thrombosis complicating severe ovarian hyperstimulation syndrome after prophylactic albumin administration. Fertil. Steril., 68, 174-176. Mozes, M., Bogokowsky, H., Antebi, E., Lunenfeld, B., Rabau, E., Serr, D.M., David, A. and Salomy, M. (1965) Thromboembolic phenomena after ovarian stimulation with human gonadotrophins. Lancet, 2, 1213-1215. Murdoch, A.P. and Evbuomwan, I. (1999) Severe complications of ovarian hyperstimulation syndrome are preventable. Hum. Reprod., 14, 2922-2923. Nappi, R.G., Di Naro, E., D'Aries, A.P. and Nappi, L. (1998) Natural pregnancy in hypothyroid woman complicated by spontaneous ovarian hyperstimulation syndrome. Am. J. Obstet. Gynecol., 178, 610-611. Navot, D., Bergh, P.A. and Laufer, N. (1992) Ovarian hyperstimulation syndrome in novel reproductive technologies: prevention and treatment. Fertil. Steril., 58, 249-261. Nawroth, F., Heinrich, J., Bruns, U. and Wood, W.G. (1996) Severe ovarian hyperstimulation syndrome (OHSS) and icterus. Hum. Reprod., 11, 2441-2442. Neau, J.P., Marechaud, M., Guitton, P., Pourrat, O., Gil, R. and Lefevre, J.P. (1989) Occlusion of the middle cerebral artery after induction of ovulation with gonadotropins. Rev. Neurol. (Paris), 145, 859-861. Nwosu, U.C., Corson, S.L. and Bolognese, R.J. (1974) Hyperstimulation and multiple side-effects of menotropin therapy: a case report. J. Reprod. Med., 12, 117-120. Olatunbosun, O.A., Gilliland, B., Brydon, L.A., Chizen, D.R. and Pierson, R.A. (1996) Spontaneous ovarian hyperstimulation syndrome in four consecutive pregnancies. Clin. Exp. Obstet. Gynecol., 23, 127-132. Ong, A.C., Eisen, V., Rennie, D.P., Homburg, R., Lachelin, G.C., Jacobs, H.S. and Slater, J.D. (1991) The pathogenesis of the ovarian hyperstimulation syndrome (OHS): a possible role for ovarian renin. Clin. Endocrinol. (Oxf.), 34, 43-49. Padilla, S.L., Zamaria, S., Baramki, T.A. and Garcia, J.E. (1990) Abdominal paracentesis for the ovarian hyperstimulation syndrome with severe pulmonary compromise. Fertil. Steril., 53, 365-367. Pappa, A., Seferiadis, K., Fotsis, T., Shevchenko, A., Marselos, M., Tsolas, O. and Messinis, I.E. (1999) Purification of a candidate gonad10aclinical course10aClinical Medicine.10acoasting10aIVF10aOHSS10atreatment.1 aDelvigne, Annick1 aRozenberg, Serge  uhttps://www.notifylibrary.org/reference/1789