| Author/Editor | Meden-Vrtovec, H; Tomaževič, T | |
| Title | Severe ovarian hyperstimulation syndrome in the IVF-ET program | |
| Type | članek | |
| Source | Assist Reprod Technol Androl | |
| Vol. and No. | Letnik 3 | |
| Publication year | 1992 | |
| Volume | str. 344-53 | |
| Language | eng | |
| Abstract | In our IVF-ET program ovulation was stimulated by hMG/hCG in 3314 cycles and with GnRH-analog (GnRH-a suprefact) hMG / hCG in 500 cycles. The signs of incipient ovarian hyperstimulation (exaggerated E2 levels and multiple small follicles on Day 7 or 8 of the stimulated cycle) were present in ten patients in hMG /hCG treated group (0.30 per cent) and developed to severe OHSS in eight patients (0.24 per cent), and in ten patients in GnRH-a, hMG, hCG group (2.0 per cent). To prevent the progress of ovarian hyperstimulation four methods were applied. (a) In one patient with excessive E2 level hCG was not administered (GnRH-a group). (b) In one patient with 22 oocytes retrieved ET was postponed to the following cycle (GnRH-a group). (c) In two patients follicles wee aspirated before hCG administration (GnRH-a group). (d) In two patients stimulated by hMG, hCG was not applied and GnRH-a was administered for 25 consecutive days. The first three methods applied in GnRH-a, hMG stimulated group were not effective and ovarian condition progressed in all the cases to severe OHSS. Only GnRH-a administration abolished all signs of hyperstimulation. The comparison of mean E2 levels, number of oocytes retrieved and embryos transferred did not differ in both groups of hyperstimulated patients (E2: hMG group: 12.5 +- 4.5 nmol/l, GrRH-a group: 11.5 +- 3.6 nmol/l; oocytes: hMG group:15 +- 6.3, GnRH-a group: 15 +- 5.5; embryos: hMG group: 5.3 +- 1.03, GnRH-a group: 5.2 +- 2.1. Conventional treatment of severe OHSS included the application of plasma volume expanders, indomethacin, aspirin/antico agulants if indicated. In four of the patient with respiratory distress, vaginal ultrasound guided aspiration of ascitic fluid was performed causing immediate improvement of objective / subjective symptoms. (Abstract truncated at 2000 characters). | |
| Descriptors | OVARIAN HYPERSTIMULATION SYNDROME FERTILIZATION IN VITRO OVULATION INDUCTION GONADORELIN GONADOTROPINS, CHORIONIC LH OOCYTES EMBRYO TRANSFER |