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There may be a degree of interpatient variability in response to menotrophin administration with a poor response in some cases. The lowest effective dose in relation to the treatment objective should be used in both men and women. Before starting treatment, the couple’s infertility should be assessed as appropriate and putative contraindications for pregnancy evaluated. In particular, patients should be evaluated for hypothyroidism, adrenocortical deficiency, hyperprolactinemia and pituitary or hypothalamic tumours, and appropriate specific treatment given. Patients undergoing stimulation of follicular growth whether in the frame of a treatment for anovulatory infertility or ART procedures, may experience ovarian enlargement or develop hyperstimulation. Adherence to recommended Merional dosage and regimen of administration and careful monitoring of therapy will minimise the incidence of such events. Accurate interpretation of the indices of follicular development and maturation require a physician who is experienced in the interpretation of such data. OHSS is a medical event distinct from uncomplicated ovarian enlargement. It is a syndrome that can manifest itself with increasing degrees of severity. It comprises marked ovarian enlargement, high serum sex steroids, and an increase in vascular permeability, pleural and rarely in pericardial cavities. The following symptoms may be observed in severe cases of OHSS: abdominal pain, abdominal distensions, severe ovarian enlargement, weight gain, dyspnoea, oliguria and gastrointestinal symptoms including nausea, vomiting and diarrhoea, turinabol 20 mg oral steroids turinabol. Clinical examination may reveal hypovolaemia, haemoconcentation, electrolyte imbalances, ascites, haemoperitoneum, pleural effusions, hydrothorax, acute pulmonary distress and thromboembolic events. 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