Human menopausal gonadotropins for anovulation and sterility

Ultrasound and hematological changes during early luteal phase in women at high risk for developing ovarian hyperstimulation syndrome

“…Thus, the presence of ascites Grade 5 or 6 alone, which is essentially the equivalent of clinical evidence of ascites, as mentioned in previous classifications 1,4,[11][12][13] , could indicate that severe early OHSS is already established.…”

“…Historically, ovarian enlargement has been considered as a marker of OHSS 11,12 . The classification by Golan et al 13 , which was the first to use ultrasound to evaluate ovarian enlargement and ascites, proposed an ovarian diameter range of 5-12 cm as a criterion for diagnosing all forms of OHSS.…”

“…Older classification systems used the vague description, 'ultrasound evidence' or 'clinical evidence' of ascites 1,4,[11][12][13] . More recently, there have been efforts to classify ascites in an objective and reproducible manner, based on the quantity of fluid accumulation within body cavities observed during ultrasound examination [17][18][19][20]26,31,36 .…”

“…Severe early OHSS was diagnosed in the presence of at least moderate (Grade 3) ascites and two or more of the following: Ht > 45%, WBC > 15 000/mm 3 , hydrothorax, dyspnea and oliguria (all as proposed by Navot et al 4 , who reorganized previous classifications by Rabau et al 11 , Schenker and Weinstein 12 and Golan et al 13 ), and enlarged ovaries (MOD > 100 mm, a modification of the 5-12-cm range proposed by Golan et al 13 ). Dyspnea was assessed subjectively by the patients.…”

“…However, despite the increasing use of a GnRH agonist trigger (5.2-36.1% of cases worldwide), hCG administration remains the most popular triggering option 9,10 . There have been several proposals for diagnosing and classifying OHSS since its initial description in 1967 1,4,6,[11][12][13][14][15][16][17][18][19][20][21] . These classification systems have widespread acceptance and have formed the basis of various official guidelines (Royal College of Obstetricians and Gynaecologists 22 and American Society for Reproductive Medicine 6 ).…”