Regarding ovulation induction and ovarian hyperstimulation syndrome (OHSS), the following statements are correct:

• A. False: OHSS is iatrogenic in almost all cases, not spontaneous.
• B. True
• C. False: Ovulation induction aims for mono-follicular, not multiple, development.
• D. False: There is no convincing evidence that fertility therapy causes a large increase in invasive ovarian cancer.
• E. True

Ovulation induction and OHSS

OHSS

• It is iatrogenic in almost all cases, occurring with sustained LH activity; the hCG trigger is a known precipitant.
• VEGF is the major mediator of increased vascular permeability (third-space fluid shift).

Goal of ovulation induction

• The aim is mono-follicular development to minimise multiple pregnancy and OHSS.

Cancer risk

Although early studies raised concern about borderline/epithelial ovarian tumours, subsequent studies found no convincing evidence of increased invasive ovarian cancer; importantly, infertility itself is a risk factor for ovarian and breast cancer, and women can be reassured that fertility therapy is unlikely to increase cancer risk.

Why A is false

OHSS is iatrogenic in almost all cases.

Why B is true

VEGF is the major mediator.

Why C is false

The aim is mono-follicular, not multiple, development.

Why D is false

There is no convincing evidence of a large increase in invasive ovarian cancer.

Why E is true

Mono-follicular development is the goal to reduce multiple pregnancy and OHSS.