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Ovarian Hyperstimulation Syndrome, Management (Green-top Guideline No. 5)

Published: 26/02/2016

This is the third edition of this guideline, previously published in 2006 with the same title.


Ovarian hyperstimulation syndrome (OHSS) is a complication of fertility treatment, which uses 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 exceeds that aimed for and results in a clinical condition with a 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 management and monitoring while awaiting resolution.

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.


Declaration of interests (guideline developers)

Dr RS Mathur FRCOG, Manchester: Dr Mathur has received support to attend academic conferences from Ferring and Merck Serono, and an honorarium from Finox for expert advice.

Mr AJ Drakeley FRCOG, Liverpool: Mr Drakeley has received consulting fees or honoraria from Ferring for attending one of their advisory board meetings, and has had commercial support from Organon for attending a meeting. He has received fees for expert testimony, and has received payment for ad hoc lectures.

Mr NJ Raine-Fenning MRCOG, Nottingham: None declared.

Mr IO Evbuomwan FRCOG, Gateshead: None declared.

Dr HMAB Hamoda MRCOG, London: Dr Hamoda has received a grant from Bisans to support a trial. He has also received commercial support for attending meetings or conferences from Merck Serono, Ferring and Marlborough.