Prevention
Physicians can reduce the risk of OHSS by monitoring of FSH therapy to use this medication judiciously, and by withholding hCG medication.
Regarding dopamine agonists as prophylaxis, a systematic review and meta-analysis concluded that prophylactic treatment with cabergoline reduces the incidence, but not the severity of OHSS, without compromising pregnancy outcomes.
OHSS may also be prevented by coasting, which is ovarian hyperstimulation in IVF without hCG administration for final maturation of follicles. A study of high risk patients showed no incidence of OHSS in 21 patients, versus ~20% in the control group. On the other hand, live birth rate may be slightly decreased, with the same study resulting in 38% in coasting vs. 45% among controls, as well as decreased cumulative live birth rate (52% vs. 59%), presumably because of more difficulty in timing oocyte retrieval with full maturation.
Read more about this topic: Ovarian Hyperstimulation Syndrome
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