How frequent is severe OHSS after GnRH-agonist triggering in high risk women: a systematic review and meta-analysis

Abstract The aim of the current systematic review and meta-analysis was to assess the incidence of severe ovarian hyperstimulation syndrome (OHSS) after triggering of final oocyte maturation with gonadotrophin releasing hormone agonist (GnRH agonist) in high risk women. The pooled incidence of severe OHSS in high risk women who did not receive any form of luteal phase support was 0% (95% CI: 0.0 to 0.0, I2=0%, random effects model, 14 data sets, 1315 women). The pooled incidence of severe OHSS in high risk women in whom hCG was added to standard luteal phase support was 1% (95% CI: 0.0 to 2.0, I2=27.02%, random effects model,10 data sets, 707 women). The pooled incidence of severe OHSS in high risk women triggered by a combination of GnRH agonist and hCG (dual triggering), who received standard luteal phase support was 1% (95% CI: 0.0 to 3.0, one study, 182 women). The incidence of severe OHSS in high risk women, is not eliminated when hCG is administered either concomitantly with GnRH agonist (dual triggering) and/or during the luteal phase after GnRH agonist triggering. On the contrary, it is eliminated when no luteal support is administered.