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Ovarian Hyperstimulation Syndrome: Epidemiology, Pathophysiology, Prevention and Management

This is said to be the first published book dedicated to all aspects of ovarian hyperstimulation syndrome. It certainly contains a comprehensive review of the clinical and scientific research published thus far. It is aimed at the clinical and scientific community involved in reproductive medicine and would certainly deserve a place in any assisted conception or infertility unit library.

It begins with a comprehensive review of the classification of the syndrome, past and present. The chapter on epidemiology rather weakly makes the point that the aggressive pursuit of high numbers of egg and embryo transfers is largely responsible for the majority of cases.

The book presents a thorough review of the research into the vasoactive, immunologic, genetic and hormonal agents linked to the development of the syndrome. The evidence for accepted methods of prevention and for new methods, such as alternatives to human chorionic gonadotrophin for ovulation induction, is reviewed. A summary is made of the current treatments available and some interesting and novel potential treatments are introduced.

There are some very personal recommendations on prevention and treatment. The evidence base for some of these recommendations is shallow but that is not surprising given the paucity of good randomised trial data. The arrangement of the chapters on complications, prediction, prevention and treatment seems strange and the juxtaposition of patient-directed information at the end of the chapter on prediction also jars. Table V.7 is not reproduced accurately and does not indicate that rates of intrauterine growth restriction are significantly higher in pregnancies where there has been ovarian hyperstimulation, as is stated.

Overall, this is a good summary of the current evidence on ovarian hyperstimulation and it should be available to all who stimulate ovaries for assisted conception. It is most likely to be referred to in those parts of the world where large numbers of eggs and embryos are pursued.

Susan Hutchon, MRCOG, Consultant Obstetrician and Gynaecologist¹

^1. Birmingham Heartlands Hospital, Birmingham, UK

Cambridge University Press, 2006
ISBN 9780521857987
Hardback, 231 pages, £40.00

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