Prediction of ovarian hyperstimulation syndrome: Challenging the estradiol mythos

Raoul Orvieto

Research output: Contribution to journalReview articlepeer-review

52 Scopus citations


Ovarian hyperstimulation syndrome (OHSS) is a serious and potentially life-threatening complication of ovulation induction. The syndrome almost always presents either after hCG administration in susceptible patients or during early pregnancy. Despite many years of clinical experience, the pathophysiology is poorly understood and there is no reliable test to predict patients who will subsequently develop severe OHSS. Nevertheless, excessive estradiol (E2) levels are commonly used as a predictor for the development of severe OHSS. The aim of this debate is to challenge this E2 mythos by demonstrating the reported versatility in the chosen E2 level in which patients develop OHSS; present pathophysiological evidence which paradoxically supports a preventive rather than a detrimental effect of E2 against OHSS, followed by a possible explanation which may sort out the aforementioned chaos. Additional studies are required to elucidate the pathophysiology of OHSS which may ultimately lead to new strategies in the prediction, prevention and treatment of severe OHSS.

Original languageEnglish
Pages (from-to)665-667
Number of pages3
JournalHuman Reproduction
Issue number4
StatePublished - 1 Apr 2003
Externally publishedYes


  • Estradiol
  • Inflammatory response
  • OHSS
  • Pathophysiology
  • Prediction

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology


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