Intra-venous fluids preventing severe ovarian hyperstimulation syndrome 

Ovarian hyperstimulation syndrome (OHSS) is a complication from some fertility medications used for controlled ovarian stimulation in women undergoing in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) cycles. Most cases are mild, but for a small proportion of women the OHSS is severe. The aetiology of OHSS is not completely clear at this moment. The ovaries become swollen with fluid, leaking this excess fluid in to the body. In extreme cases, which are rare, the fluid may fill the chest area leading to shortness of breath. Other symptoms of serious OHSS include weight gain of more than 10 pounds in a few days, severe pain or swelling in the abdomen and trouble urinating. Data from many studies suggest that giving intra-venous colloid fluids, such as human albumin, hydroxyethyl starch, dextran or Haemaccel, at the time of oocyte retrieval may be beneficial for women with a high risk of developing OHSS. To obtain a reliable assessment of the effects of intra-venous fluids, we reviewed data from nine randomised controlled studies. There was borderline evidence of benefit with the routine use of human albumin in the prevention of OHSS. There was good evidence to support the use of hydroxyethyl starch in the prevention of OHSS in high risk patients.