Regarding in vitro fertilization (IVF) complications, ovarian hyperstimulation syndrome (OHSS) severe form is characterized by which finding?

• A Mild abdominal distension with ovaries <8 cm and no hemoconcentration
• B Ovarian enlargement >10 cm, massive ascites, hemoconcentration (Hct >45%), oliguria ✓
• C Severe OHSS requires Hct >60% and anuria to be classified
• D Ovarian enlargement >5 cm with nausea but no ascites

Explanation

Severe OHSS (RCOG/ESHRE classification) includes ovarian enlargement typically >10 cm, clinically apparent ascites (massive), hemoconcentration (hematocrit >45%), leukocytosis >15,000/µL, oliguria (<600 mL/day), hyponatremia, hypoproteinemia, and possible pleural effusion. The key pathophysiology is increased vascular permeability driven by VEGF, causing fluid shift from intravascular to third-space compartments. Critical OHSS additionally includes anuria, acute renal failure, tense ascites, DVT, or ARDS. Hct >60% indicates critical OHSS.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

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Written and medically reviewed by the StethoPrep medical team.