Decreasing fertility of the population, related to the higher age of primigravidae among other thing, leads to the fact, that people more and more frequently turn to the assisted reproduction centers. Methods of in vitro fertilization nowadays help many infertile couple start a family. However, every intervention into the organism has an adverse effect. In the algorithm, we face the serious complication of pharmacological ovarian stimulation.
Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication of stimulated ovulation within modern procedures of assisted reproductive technology, which is nowadays still on the rise. In predisposed women, this process may get out of control and the activation of many neurohumoral systems results in OHSS. The incidence moves between 0,5-11% of all IVF(in vitro fertilization) patients, severe life-threatening form occurs in 0,1-2% of stimulated cycles. The state is characterized by significant cystic ovarian enlargement, high capillary permeability with fluid leakage to the third space, hypovolemia and hypercoagulation. Next complications are dysfunction or final organs failure as the consequence of hypoperfusion and thromboembolic event. The algorithm illustrates the issue very practically and leads the investigator logically step by step to the right therapy in clinical practice.
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