Good follow up question! See my reply above but yes, hCG worsens OHSS. This is not only from an hCG trigger but also from a fresh transfer that implants and begins making hCG. This is the theory behind using agonist triggers and avoiding fresh transfers when OHSS is suspected.

Unfortunately not all OHSS can be avoided. We can just use certain approaches to lessen the duration of the OHSS and reduce the risk of worsening symptoms.