OHSS is a complication of fertility treatment with pharmacological ovarian stimulation to increase the number of oocytes, and therefore embryos, available during assisted reproductive technology (ART).
In a minority of women undergoing treatment, the ovarian response is excessive and results in this clinical condition and specific pathophysiology. OHSS is associated with significant physical and psychosocial morbidity and has been associated with maternal death. However, in most cases OHSS is self-limiting and requires supportive care and monitoring while awaiting resolution. Those with severe OHSS may require inpatient treatment to manage symptoms and reduce the risk of further complications.
Women with more severe OHSS may require inpatient treatment to manage the symptoms and reduce the risk of further complications. Prevention of OHSS is outside the scope of this guideline and is covered by guidance from the British Fertility Society and European Society of Human Reproduction and Embryology.
Version history:
This is the fourth edition of this guideline. The first edition was published in 1995 as Management and Prevention of Ovarian Hyperstimulation Syndrome. This edition was archived in 1998 when NICE incorporated elements of the topic into Clinical Guideline 11 on fertility. The second edition and third edition of this guideline were published in 2006 and 2016.
Developer declaration of interests:
Dr RS Mathur FRCOG, Manchester: Dr Mathur has received payment for providing medicolegal expert opinion on behalf of claimants and defendants in cases in the field of fertility.
Mr AJ Drakeley FRCOG, Liverpool: Mr Drakeley has received a speaker fee from Ferring.
Mr IO Evbuomwan FRCOG, Gateshead: None declared.
Dr HMAB Hamoda MRCOG, London: Dr Hamoda has received payment for providing medical expert opinion in the field of reproductive medicine and surgery.
Ms K Brian: None declared.