Author/Editor		Tomaževič, T; Meden-Vrtovec, H; Bokal-Vrtačnik, E; Zorn, B; Veble, A; Valentinčič, B; Virant-Klun, I; Kermavner-Bacer, L
Title		Unilateral early timed follicular aspiration (EFTA) 10-12h after hCG prevents the syndrome of serious ovarian hyperstimulation
Type		članek
Source		In: Coutinho EM, Spinola P, editors. Current knowledge in reproductive medicine. Proceedings of the 10th world congress on human reproduction; 1999 May 4-8; Salvador. 1st ed. Amsterdam: Elsevier science,
Publication year		2000
Volume		str. 81-8
Language		eng
Abstract		Unilateral early timed follicular aspiration (EFTA) of one ovary 10-12 h after the administration of chorionic gonadotropin in IVF/ET cycles at high risk for severe ovarian hyperstimulation syndrome (SOHSS), is an attempt to prevent SOHSS. After the introduction of preventive unilateal EFTA, SOHSS completely disappeared from the Ljubljana IVF/ET program. We evaluated the significance of this observation by analysing the data on 821 cycles at high risk for SOHSS performed during the years 1987-1999. In all cycles the high risk for SOHSS was defined by the estradiol values > 3000 pg/ml and more than eight follicles > 14 mm plus intermediate and small follicles in each ovary on ultrasound. First: in the group of 234 female infertility cycles at high risk for SOHSS with preventive EFTA there were no cases of SOHSS. In the control group og 92 IVF/ET female infertility without EFTA there were 12 cases of SOHSS (p<0.0001). No difference in live birth rate of (17% vs. 16%) was noted. Second: the preventive effect of EFTA was repeatedly found in the group 495 IVF cycles for different infertility indications at high risk for SOHSS with unilateral EFTA performed between 1996 and 1999. The live birth rate in 495 IVF cycles at high risk for SOHSS was 16%. The live birth rate in the subgroup of 198 IVF/ET cycles with ICSI it was 20%. The preventive effect of follicular aspiration is timing dependent and is based on aspiration of follicular fluid with paracrine substances important for final follicular muturation and corpus lutem formation. In 30% of 495 IVF cycles at high risk for SOHS with unilateral EFTA there were spare embryos left for cryopreservation. We conclude that EFTA is another successful option to decrease the incidence of severe OHSS in assisted reproduction.
Descriptors		OVARIAN HYPERSTIMULATION SYNDROME OVULATION INDUCTION GONADOTROPINS, CHORIONIC FERTILIZATION IN VITRO EMBRYO TRANSFER FOLLICULAR PHASE OOCYTES