O&G · Reproductive endocrinology & infertility

OHSS and fertility-treatment complications — Golan grading, VEGF pathophysiology, prophylaxis (cabergoline, GnRH antagonist trigger), and ICU management

Also known as Ovarian hyperstimulation syndrome · OHSS · Fertility treatment complications · Severe OHSS · Critical OHSS · GnRH agonist trigger

Exam-exhaustive FRANZCOG fellowship topic on ovarian hyperstimulation syndrome and fertility-treatment complications. Anchored to the RANZCOG CREI consensus (2015), the ASRM Practice Committee opinion, and the ESHRE ovarian-stimulation guideline. Covers the Golan classification (mild / moderate / severe / critical, with reproductive endocrinology modification), the VEGF-mediated capillary-leak pathophysiology, the recognition (ovarian size, haematocrit, oliguria, ascites), the prophylaxis ladder (GnRH antagonist protocol with agonist trigger, prophylactic cabergoline 0.5 mg daily, low-dose hCG trigger, freeze-all), the supportive management (crystalloid then colloid, paracentesis, thromboprophylaxis, ICU for severe and critical disease), the long-term implications for ovarian function, and the rare but life-threatening complications (thromboembolism, ARDS, torsion). Globally defensible at MRCOG Part 2/3 and ABOG level.