<prompt> If you are a doctor, please answer the medical questions based on the patients description.Hi, My wife underwent IVF on 10th December 2009. ER Egg Retrieval was successful on that day .18 oocytes were recovered .but after two days pain started in her lower abdomin area and started increasing .The ART Specilist stopped the procedure of ETEgg transplant as ultrasound confirmed OHSSOvarian Hyper Stimulation Syndrom .Ovaries size had increased BL Ovaries enlarged and cystic rt ovary - 8 cm, lt ovary - 7 cm, free fluid ve . She was hospitalised for 3 days.Specilist suggested Periodic Ultrasound . FETFrozen Embryo Transplant was planned after 2 months.After two montys no ET was done, as the thawed embryos were not of good quality as per the specialist Embryos frozen : 4 Grade 1A2B . Medicine Suggested presentlly is Metformin- 1500mg, folic acid, colsprin - 75 mg. These continued through out. Second cycle of IVF suggested from next day 21started on 16 apr 2010 with Lupride 12 cc injections . Some details: 1. Female Age : 31 2. Height : 173cm 3. Weight : 70 4. Reason of Infertility : PCOD Polycystic Ovarian Disease, 5. Have you had any pelvic surgery? yes 6. Surgery Name : Adhesiolysis Ovarian Drilling Done on both sides Year : 2006 7. Findings : Both ovaries polycystic, fallopian tubes open 8. Medical problems and current medications of female partner: Suspected uterine Tuberculosis, had ATT AKT - 2 4medicines for 6 months. 9. In vitro fertilization IVF : yes Date : 10 Dec 2009 Stimulation Protocol : D21 onwards : Lupride 12 cc 141109 to 81209 23 inj, GonalF 225 ml 11209 to 41209 4inj, ChatDoctor 81209 at 1 o clock at night Dose of Hmg :300 Days of Hmg :D5,6,7 51209 to 71209 Follicles grown :18-20 Eggs collected :15 10122009 Embryos formed :4 Embryos transferred :0 Embryos frozen :4 Grade 1A2B My Question : 1. Is it possible that OHSS may reoccur 2. I want to reduce chances of OHSS. Please suggest how to go about it.  <response>: Hello there, thanks for writing in. I would like to discuss a few things with you. HSS of severe degree is considered unacceptable these days with the introduction of antagonist protocol agonist protocol as used in your case is more susceptible to develop HSS, especially in PCs women who are very prone to develop HSS. So next time when you undergo stimulation the choice should be an antagonist protocol which significantly reduces the chances of HSS. Using metformin through ovarian stimulation will also bring down HSS risks. Using GRH agonist as a trigger for final maturation of eggs in place of Chat Doctor will aid. At the same time the eggs can be frozen and transferred at a later date in FET. Using lower dose and gradually increasing the dose to obtain a response response is growth of multiple follicles should be considered. Some physicians administer albumin infusion at the time of egg retrieval to prevent HSS. Hope the above provided information will assist you to discuss the strategies with your doctor regarding your concern. Take care. 