Navigating through OHSS with gnrh agonist triggers and low-dose hCG for luteal support

Abstract

Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication of assisted reproductive technologies. It is characterized by increased vascular permeability and fluid shift to the third space, resulting in hemoconcentration and hypovolemia. Regarding the timing of the symptoms, OHSS is further categorized as early and late. Early OHSS is observed within seven days of the trigger injection, while late OHSS appears later on. Although human chorionic gonadotropin (hCG) is the primary driver for both early and late OHSS, it is the endogenous hCG of pregnancy that causes the prolonged and more severe late OHSS. Several strategies have been described to prevent OHSS (1, 2).