Interventions for the prevention of OHSS in ART cycles: an overview of Cochrane reviews

Abstract

Currently, 27 reviews in the Cochrane Library were conducted to report on or to try to report on OHSS in ART cycles. We identified four review protocols but no new registered titles that can potentially be included in this overview in the future. This overview provides the most up-to-date evidence on prevention of OHSS in ART cycles from all currently published Cochrane reviews on ART. Clinicians can use the evidence summarised in this overview to choose the best treatment regimen for individual patients - a regimen that not only reduces the chance of developing OHSS but does not compromise other outcomes such as pregnancy or live birth rate. Review results, however, are limited by the lack of recent primary studies or updated reviews. Furthermore, this overview can be used by policymakers in developing local and regional protocols or guidelines and can reveal knowledge gaps for future research.

Assisted reproductive technology in Japan: A summary report for 2016 by the Ethics Committee of the Japan Society of Obstetrics and Gynecology

“…There was a significant transition to the freeze‐all policy (Table ). Freeze‐all provides an effective treatment option for patients at high risk for ovarian hyper‐stimulation syndrome (OHSS), preventing the symptoms and severity becoming worse . A randomized controlled trial (RCT) in China demonstrated that the freeze‐all strategy had a significantly decreased risk for adverse outcomes such as OHSS and miscarriage, and a significantly higher rate of live birth among polycystic ovary syndrome (PCOS) patients .…”

GnRH Antagonist Versus Modified Prolonged GnRH Agonist Protocol in Polycystic Ovary Syndrome (PCOS): Analysis Using Propensity Score Matching

“…Controlled ovarian hyperstimulation (COH) is still a big challenge in women with PCOS due to the abnormal endocrine and metabolic environment. The GnRH-ant protocol has been widely accepted as a prominent intervention to reduce the risk of OHSS [13], and been recommended by WHO as a COH choice for PCOS patients [13]. This study was the rst one to compare the mGnRH-a ptotocol and the mainstream GnRH-ant protocol from aspects of live birth rate, safety and economic cost.…”

“…The balance between the desire for pregnancy and the patients' safety is a top priority. From the existing evidence, the GnRH antagonist protocol is bene cial in reducing the risk of OHSS [13]. However, no study has investigated the clinical outcome of the mGnRH-a protocol in women with PCOS.…”

Randomized trial of combined cabergoline and coasting in preventing ovarian hyperstimulation syndrome during in vitro fertilization/intracytoplasmic sperm injection cycles

“…Coasting is a well‐known and effective method for preventing OHSS, provided it is performed in line with proper guidelines. A recent Cochrane review reported coasting to be a promising intervention for OHSS that requires further research.…”