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Grading and Classification of Ovarian Hyperstimulation Syndrome (OHSS)

OHSS Grade OHSS Classification Description
Mild I Abdominal bloating and discomfort
II Grade I symptoms plus nausea, vomiting, and/or diarrhea. Ovaries are enlarged to varying degrees, with a diameter not exceeding 5 cm
Moderate III Worsening of mild OHSS symptoms, ultrasound evidence of ascites, ovarian diameter between 5-10 cm
Severe IV Moderate OHSS features, clinical evidence of ascites
V Hematocrit >45% (increase >30% from baseline), WBC >15000/mL, oliguria, serum creatinine 1.0-1.5 mg/dL, creatinine clearance ≥50 mL/min
Critical VI Tense ascites (with or without pleural effusion), hematocrit >55%, WBC >25000/mL, serum creatinine >1.6 mg/dL, creatinine clearance >50 mL/min, thromboembolism, acute respiratory distress syndrome (ARDS)
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