Modified Golan classification of ovarian hyperstimulation syndrome

Last revised by Joshua Yap on 27 Apr 2023

The modified Golan classification of ovarian hyperstimulation syndrome, employing clinical findings and imaging appearances, is used to categorize ovarian hyperstimulation syndrome (OHSS) into the following three categories of severity with five grades 1,2:

  • mild OHSS: characterized by bilateral multicystic ovarian enlargement

    • grade 1: abdominal distention and discomfort

    • grade 2: grade 1 with nausea, vomiting and/or diarrhea, and ovarian enlargement from 5-12 cm

  • moderate OHSS: characterized by ascites and abdominal distension

    • grade 3: features of mild OHSS with ultrasonographic evidence of ascites

  • severe OHSS: characterized by hypovolemia, hemoconcentration, thrombosis, oliguria, pleural and pericardial effusion

    • grade 4: moderate OHSS with clinical evidence of ascites and/or hydrothorax and dyspnea

    • grade 5: grade 4 with change in blood volume, hemoconcentration, coagulation abnormalities, and diminished renal perfusion and function

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Cases and figures

  • Case 1: grade 5 with hypovolemic shock
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