ABSTRACT
Primary prevention and early recognition of ovarian hyperstimulation syndrome (OHSS) are important in order to ensure the patient’s safety. The first step of primary prevention is the iden tification of risk factors, to individualize the patient’s stimulation regimen. Second, it is mandatory to monitor the ovarian response to gonadotropins strictly in order to adapt the stimulation to this response. For this purpose, monitoring ovulation using ultrasound and serum estradiol (E2) assays constitutes the ‘gold standard’. Several studies have evaluated the impact of follow-up by either technique alone or in combination, and concluded that the combi nation of both methods provides the best results1. Nevertheless, while it is believed that both E2 and ultrasound monitoring is necessary, it is insufficient, as most in vitro fertilization (IVF) centers still report the occurrence of severe forms of OHSS, even though such moni toring is practiced2.
