Reviewer’s report
Title: 
ARE ANTHROPOMETRIC DATA A TOOL FOR DETERMINING THE
SEVERITY OF OHSS? YES, IT COULD BE!
Version: 
1 
Date: 
13 Jan 2022
Reviewer's report:
ABCSTRACT
In results you mention twice, that median of APD/TS was significantly lower in
patients with moderate OHSS compared to severe of critical OHSS. However,
there is a difference in the data of median values in brackets.
BACKGROUND
I would strongly recommend the restructuring of some sentences, perhaps from a
native speaker.
METHODS
Characteristics of the sample should be described in this particular article too,
not just stated in references for another article.
Is the sample size of the group with critical OHSS big enough? Elaborate.
How was the measurement of the abdominal free fluid index approached? Was it
measured in four different quadrants of the abdomen or just the deepest pocket of
fluid?
RESULTS
The age range and BMI range of the participants should be stated in the methods
section, not in results.
You stated twice that there was a significant difference of median APD/TS in the
group with moderate OHSS compared to groups with severe and critical OHSS.
The same statistically significant results are presented for measurement of APD
alone. Could the APD measurement alone be just as representative as the
measurement of APD/TS.
You stated that there is a weak inverse correlation of APD/TS with WC, which is
illogical. It would make sense to discuss that inverse correlation in the
discussion. You measured the WC and BMI only once for each patient and did
not evaluate the changes in those values over time. For the evaluation of the
severity of the disease, the changes in those values for each patient are the most
important.
DISCUSION
You mention that you obtained no significant differences of BMI and WC
between groups with moderate, severe and critical OHSS. Sample weight
distribution of participants was from 16,9 to 24,1 kg/m^2. In my opinion the
weight of the participants was not diverse enough for the data to be
representative. Especially because of the data that supports the PCOS (patients
with generally higher BMI) as a risk factor for severity of the disease.
Sample size, weight distribution of participants and illogical results should be
discussed.
You mention a HC abbreviation that wasn't explained beforehand. 
Your result show no significant difference of WC in different groups of OHSS.
How do you compare those results with the already proven significant
correlation of AsI and IAP with OHSS severity. 
You state that a change from an ellipse to spheric shape of abdomen is corelated
with maximum increase in IAP values because of the natural characteristics of
abdominal compliance. You also state that from your results there was no
statistically proven difference between medians of APD and APD/TS in groups
of severe and critical OHSS. It would be logical, that in those two groups the
medians of APD/TS and APD would be the most different. I would advise
discussion about those conflicting results.
In mild or moderate cases of OHSS most of the cases are usually outpatients.
Outpatients should be monitored with simple and relatively reliable
measurements like the change in body weight and abdominal circumference.
You stated, that moderate OHSS can progress to severe OHSS within a few
hours. What is the purpose of measuring the APD and TS that can be performed
only with the pelvimeter? For outpatients, only simple and relatively reliable
measurements like changes in body weight and abdominal circumference could
be applicable. 
The potential benefits of measuring the APD or APD/TS would therefore be for
hospitalised patients, mostly presenting groups with severe or critical OHSS. But
your results show no statistically significant difference in those two groups. 
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
No
Is the use of statistics and treatment of uncertainties appropriate?
No
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No
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes