Preventing severe OHSS has many different facets

Dopamine agonists, decreased FSH and hCG doses, coasting, agonist trigger, paracentesis, metformin, low-dose aspirin, anticoagulation, and possibly FSH co-trigger are measures that prevent or reduce the severity of OHSS.


David R. Meldrum, M.D.

Volume 97, Issue 3, Pages 536-538


Only 20 years ago we had no understanding of what causes OHSS. The review by Soares (1) chronicles a remarkable story defining granulosa cell (GC) VEGF as the mediator of this syndrome, culminating in treatment with dopamine agonists that block VEGF receptor expression as the cause of increased vascular permeability. I was fortunate to be part of an elegant study by Levin and colleagues (2) using a bioassay for vascular permeability showing that 98% of the bioactivity of follicular fluid in high responders was blocked by an anti-VEGF antibody.

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