Autologous protein reinfusion in severe ovary hyperstimulation syndrome

Ovarian hyperstimulation syndrome (OHSS) is one of the most serious complications of ovulation induction by exogenous gonadotropins. The pathophysiologic factors of this syndrome are not well known. Increased capillary permeability causes third space fluid shift, which is responsible for ascites, pleural fluid, and edemas. Severe OHSS may result in renal failure, hypovolemic shock, thromboembolic disease, respiratory distress, and may cause death. It has been observed that paracentesis is efficacious, provided that care is taken to reinfuse protein lost in the peritoneal exudate. For this reason, in three patients with severe OHSS we have used a dialytic technique of reinfusion of concentrated ascitic fluid.