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Table 2 Risk factors/predictive factors for OHSS (adapted from Humaidan et al [10])

From: Predicting and preventing ovarian hyperstimulation syndrome (OHSS): the need for individualized not standardized treatment

Risk factor Threshold of risk
Primary risk factors (patient related)
· High basal AMH - >3.36 ng/mL independently predicts OHSS [12]
· Young age - <33 years predicts OHSS [12]
· Previous OHSS - Moderate and severe cases, particularly those with hospitalization
· PCO like ovaries - >24 antral follicles in both ovaries combined
Secondary risk factors (ovarian response-related)
On day of hCG trigger  
· High number of medium/large follicles - ≥13 follicles ≥11 mm in diameter [14] - >11 follicles ≥10 mm in diameter [12]
· High or rapidly rising E2 levels and high number of follicles - E2 5,000 ng/L and/or ≥18 follicles predictive of severe OHSS [14]
· Number of oocytes retrieved - >11 predicts OHSS [12]
· VEGF levels - Not applicable
· Elevated inhibin-B levels - Elevated levels on day 5 of gonadotropin stimulation, at oocyte retrieval and 3 days before
· hCG administration for LPS - Not applicable
· Pregnancy (increase in endogenous hCG) - Not applicable
  1. AFC = antral follicle count; AMH = anti-Müllerian hormone; E2 = estradiol; hCG = human chorionic gonadotropin; LPS = luteal phase support; OHSS = ovarian hyperstimulation syndrome; PCOS = polycystic ovary syndrome; VEGF = vascular endothelial growth factor.