Molecular markers for predicting ovarian hyperstimulation syndrome severity and response to preventive therapy: the prospects of personalized medicine

Ovarian hyperstimulation syndrome (OHSS) remains a potentially life-threatening complication of assisted reproductive technologies (ART), particularly in women with high ovarian reserve. The objective: to determine the prognostic value of molecular markers (VEGF, IL-6, TNF-α, HE-4, Ki-67, HOMA index) in predicting severe OHSS and to evaluate the effectiveness of personalized preventive therapy. Sixty high-risk women were included and divided into two subgroups.Materials and methods. Group I received standard preventive protocols, while Group II underwent an advanced strategy with individualized interventions.Results. In Group II, the mean VEGF level was 282.4±24.7 pg/mL compared to 434.6±33.1 pg/mL in Group I (p < 0.01); IL-6 levels were 8.9±1.2 pg/mL vs. 15.6±2.1 pg/mL, respectively (p < 0.01). The incidence of severe OHSS was significantly reduced from 16.7% in the standard group to 3.3% in the personalized group (p < 0.05). The clinical pregnancy rate in Group II reached 50% compared to 35% in Group I (p = 0.04), while early miscarriage rates decreased from 20% to 10% (p = 0.05). Conclusions. These findings confirm the high clinical value of integrating molecular biomarker monitoring with optimized preventive protocols for reducing OHSS risk and improving reproductive outcomes.Keywords: ovarian hyperstimulation syndrome; molecular markers; VEGF; IL-6; personalized medicine; dopamine agonists; GnRH antagonists; HOMA index; freeze-all strategy; assisted reproductive technologies.