Managing ovarian hyperstimulation syndrome (OHSS): can kisseptin reduce the risk?

This study investigated the effects of kisseptin on the risk of ovarian hyperstimulation syndrome (OHSS) in high-risk women undergoing fertility treatment. The authors suggested that kisseptin treatment resulted in lower rates of OHSS compared to standard treatment. 

One of the first procedures for the treatment of infertility is harvesting of oocytes (eggs) from the ovaries. In order to achieve this, a woman will receive an injection of a drug or hormone that will stimulate the ovaries. One potential side effect of this procedure is ovarian hyperstimulation syndrome (OHSS). OHSS can cause painful, swollen ovaries, which can lead to a serious increase in fluid in the abdomen or chest. 

The hormone human chorionic gonadotrophin (hCG) is most often used to stimulate oocyte release. hCG has a duration of action of 7-10 days. This feature may contribute to the risk of OHSS.

Kisseptin is a new medication that can also be used to stimulate the ovaries. It is a peptide (protein) that can stimulate the body to produce gonadotrophin-releasing hormone (GnRH). It is classified as a GnRH agonist (GnRHa). Kisseptin has a much shorter duration of action and causes a lower level of stimulation. 

This study investigated if kisseptin has a lower risk of OHSS in women undergoing treatment to trigger oocyte release.

This study included 234 women with high risk of OHSS undergoing ovarian stimulation. Patients received either hCG, kisseptin or another GnRHa to induce oocyte release. Clinical parameters of OHSS were measured in all patients. This included ovarian volume and abdominal volume.

hCG and GnRHa treatment resulted in a significant increase in ovarian volume compared to kisseptin. hCG caused an increase of 33 ml of abdominal fluid compared to kisseptin. Rates of OHSS were 45% in patients who received hCG, compared to 30% who received GnRHa and 12% who received kisseptin.

This study concluded that kisseptin treatment resulted in lower rates of OHSS compared to standard treatment.

This was a retrospective study. As a result, the treatment regimes differed between patients and some parameters were measured at different times (e.g. 2-6 days following treatment). A randomized, controlled trial is needed to determine the benefits of kisseptin or other GnRHa medications. 

If you have any concerns regarding OHSS and fertility treatment, please discuss with your doctor.