Contemporary Approach towards Etiology, Pathogenesis and Classification of Ovarian Hyperstimulation Syndrome (Review)
Ovarian hyperstimulation syndrome (OHSS) is a complex complication of ART involving supraphysiological hormone levels, increased inflammatory mediators, endothelial dysfunction, and leading to hypovolemia, organ dysfunction, and potential thromboembolism.
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The paper is a literature review on the etiology, pathogenesis, and classification of ovarian hyperstimulation syndrome (OHSS), described as one of the most dangerous iatrogenic complications of controlled ovarian stimulation in assisted reproductive technologies, with a reported incidence up to 33% of ART cycles. It outlines OHSS as a multi-step process beginning with supraphysiologic hormone concentrations of both exogenous and endogenous origin, leading to increased production and release of biologically active and pro-inflammatory mediators (including VEGF, soluble vascular endothelial (cadherin), IL-1/IL-2/IL-6/IL-8, and TGF-β) and excessive activation of the renin-angiotensin-aldosterone system. The review emphasizes systemic endothelial dysfunction as the key event driving capillary permeability, resulting in hypovolemia, hemoconcentration, abdominal compartment syndrome, systemic inflammatory response, and sometimes multi-organ failure, thromboembolic complications, and acute respiratory distress syndrome. This paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.
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Cites (3)
- Ovarian hyperstimulation syndrome: A review for emergency clinicians 2019
- TGF-β1 induces VEGF expression in human granulosa-lutein cells: a potential mechanism for the pathogenesis of ovarian hyperstimulation syndrome 2020
- The Dual Role of PEDF in the Pathogenesis of OHSS: Negating Both Angiogenic and Inflammatory Pathways 2016
References (64)
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