Ovarian hyperstimulation syndrome (OHSS) is a dangerous iatrogenic complication of ovulation induction (1). Though it is a rare (2) or an uncommon (3) condition its true incidence is difficult to delineate as a strict consensus definition is lacking (3) . The incidence ranges from of 33 % in mild cases to 3-6 % in moderate cases while reaching only 1-2% in severe cases (4,5). These severe cases are life-threatening conditions that could be fatal. Furthermore, the pathophysiology of this condition is not fully clear, understanding it helps identifying preventive and treating modalities (6).

This study was an interventional comparative clinical trial including eighty patients with high risk for ovarian hyperstimulation attended to the infertility clinic/ center of Obstetrics and Gynaecology department , El Minia University Maternity hospital , El Minia , Egypt and in private centers and undergoing ovulation induction using GnRH agonist down regulation protocol for ICSI cycles . Patients was divided into two groups according to the drug regimen used for OHSS risk prevention. The study was conducted between April 2019 and April 2020 after approval of the study protocol by the Ethical Committee of and all participants will sign an informed written consent form.