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Ovarian Hyperstimulation Syndrome: Epidemiology, Pathophysiology, Prevention and Management. First Edition. Edited by: Botros R.M.B. Rizk. CambridgeUniversity Press. New York, USA, 2006.

Ovarian hyperstimulation syndrome (OHSS) is a life-threatening iatrogenic complication of gonadotrophin administration. Worldwide, more than 500,000 in vitro fertilization (IVF) cycles are performed every year; and five to six times this number of superovulation cycles is performed. Therefore, severe OHSS will be encountered in small numbers by individual centers, although large numbers of cases will occur worldwide. This has led to 1ack of expertise in dealing with the myriad of complications of OHSS, especially because of their multisystem effects.

A foreword by professor Robert G. Edwards introduces this comprehensive textbook. Dr. Botros Rizk is highly talented and presents a text that is well balanced between the description of OHSS, its causes and effects, and means of controlling its very serious complications.

The structure of the book is simple, with eight chapters covering all important areas. Chapter 1 dealt with classification of ovarian hyper-stimulation syndrome, starting with the first classification by Rabau et al., 1967 followed by successive modifications reaching the most recent classification with further modifications that were introduced in 1999 by Rizk and Aboulghar. Chapter II on epidemiology of OHSS emphasizes which groups of patients are at risk, taking into consideration patient characteristics and treatment protocols. The author urged the establishment of an international registry by the American Society for Reproductive Medicine and the European Society for Human Reproduction and Embryology.

The pathophysiology of OHSS is where all the recent research developments have occurred, and in Chapters III and IV the author discussed in-depth the molecular biology research over the last decade and emphasized that these developments should stimulate basic science researchers to unlock knowledge not only of hyperstimulation but also of routine ovulation induction.

In Chapter V the detailed discussion of the complications of OHSS should prepare clinicians for difficulties they may encounter. Prediction and prevention of OHSS are covered in chapter VI and VII respectively. Chapter VIII focuses on outpatient and inpatient treatment, as well as intensive care and novel medical therapies that we may see in the next few years.

This book provides a clinical guide that will help those practicing in the field of assisted reproduction and infertility. The infertility specialist will find the book a resource on how to evaluate patients before starting fertility treatment, with attention onto how to avoid the development of OHSS by a series of well-chosen decisions. The scientist reading this book will realize that recent discoveries in receptor mutations emphasize that only systematic scientific research can provide real understanding of the pathophysiology of OHSS, and the potential for change.

Mohamed Aboulghar, M.D.
Professor in Obstetrics and Gynecology
Faculty of Medicine, Cairo University