Severe Early-onset Ovarian Hyperstimulation Syndrome following Use of GnRH Agonist Trigger along with Low-dose hCG

Abstract

ABSTRACTControlled ovarian hyperstimulation, which is a key component of assisted reproductive technology (ART) treatment, can be excessive in certain cases and can lead to massive cystic enlargement of the ovaries and biochemical changes, leading to ovarian hyperstimulation syndrome (OHSS). Traditionally, human chorionic gonadotropin (hCG) has been used as ovulation trigger in ART cycles but its sustained luteotrophic effect is associated with an increased risk of OHSS in high-risk patients. Gonadotropin-releasing hormone (GnRH) agonist trigger can be used as an alternative to hCG in GnRH antagonist downregulated cycles. However, the use of GnRH agonist was associated with a lower pregnancy rate due to deficient luteal phase, and hence, use of low-dose hCG to rescue the deficient luteal phase has been used. Various studies showed that using lowdose hCG did not increase the risk of OHSS even in high-risk patients. Here, we present a case report of severe early-onset OHSS following GnRH agonist trigger with low-dose hCG.How to cite this articleThomas S, Kamath MS, Muthukumar K, Aleyamma TK. Severe Early-onset Ovarian Hyperstimulation Syndrome following Use of GnRH Agonist Trigger along with Low-dose hCG. Int J Infertil Fetal Med 2016;7(2):68-72.