Factors associated with ovarian hyperstimulation syndrome (OHSS) and its effect on assisted reproductive technology (ART) treatment and outcome

Luke, Barbara; Brown, Morton B.; Morbeck, Dean E.; Hudson, S.B.; Coddington, Charles C.; Stern, Judy E.

doi:10.1016/j.fertnstert.2009.05.092

Cited by 106 publications

(71 citation statements)

References 34 publications

(36 reference statements)

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“…Although a number of strategies to reduce risk of severe OHSS have been developed (69), none are perfect, and 1-2% of young women undergoing IVF superovulation will require hospitalization. Of these, 30 -50% will have abdominal paracentesis, and an increased proportion may experience adverse pregnancy outcome (70,71). Major complications including large pleural and pericardial effusions and thromboembolic phenomena can occur, and deaths have been reported (72).…”

Section: Hypersecretory States-pcos and Risk Of Ohssmentioning

confidence: 99%

“…Both biochemical and biophysical markers predictive of hyperresponse have been explored. Once a patient at increased risk has been identified, the management of the stimulation cycle can be adjusted to reduce the dose of FSH, to use a GnRH antagonist rather than an agonist to prevent premature luteinization, to avoid the use of human chorionic gonadotropin for final oocyte maturation by substitution with a GnRH agonist in an antagonist cycle, to freeze all oocytes to avoid embryo transfer, or to avoid treatment with FSH altogether and resort to in vitro maturation of immature oocytes collected in a natural ovarian cycle (71). Detailed exploration of these approaches is beyond the scope of this review, but all depend on identification of the "at-risk" patient.…”

Section: Hypersecretory States-pcos and Risk Of Ohssmentioning

confidence: 99%

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Clinical Utility of Measurement of Anti-Müllerian Hormone in Reproductive Endocrinology

Ledger

2010

The Journal of Clinical Endocrinology & Metabolism

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Development of novel antibodies directed against anti-Müllerian hormone (AMH) has allowed measurement in serum and immunohistochemical assessment in tissues. AMH is secreted by granulosa cells in late preantral and small antral follicles and appears in serum in detectable and stable amounts throughout the menstrual cycle. AMH measurement allows an assessment of ovarian reserve with several advantages over other biochemical and biophysical markers. Recent research has highlighted utility in cases of premature ovarian failure, either iatrogenic after treatment for cancer, or naturally occurring, in polycystic ovary syndrome and in the management of superovulation in assisted reproduction. A surge in research activity has taken place over the last 5 yr, and the true place of AMH in reproductive medicine remains to be fully elucidated, but the rapid and widespread adoption of AMH assay into clinical practice demonstrates the degree of interest in this new marker amongst reproductive endocrinologists.

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Section: Hypersecretory States-pcos and Risk Of Ohssmentioning

confidence: 99%

Section: Hypersecretory States-pcos and Risk Of Ohssmentioning

confidence: 99%

Clinical Utility of Measurement of Anti-Müllerian Hormone in Reproductive Endocrinology

Ledger

2010

The Journal of Clinical Endocrinology & Metabolism

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“…We found only one polymorphism to be moderately associated with OHSS development when corrected for co-variates (age, race) known to be independent predictors of OHSS risk [8,49]. The rs2305945 G/T genotype was associated with a reduced likelihood of OHSS (OR = 0.30; 95% CI = 0.10, 0.93) in an overdominant model.…”

Section: Discussionmentioning

confidence: 92%

“…Potentially life threatening, OHSS leads to hospitalization in 1.9% of IVF cases [7]. Moderate to severe OHSS may be underestimated since many such cycles are frequently cancelled or result in the cryopreservation of all embryos [8]. Mild OHSS is relatively common with symptoms including abdominal bloating and mild weight gain.…”

Section: Introductionmentioning

confidence: 99%

Kinase insert domain receptor/vascular endothelial growth factor receptor 2 (KDR) genetic variation is associated with ovarian hyperstimulation syndrome

O’Brien

Harralson

Tran

et al. 2014

Reprod Biol Endocrinol

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BackgroundThe objective of this investigation was to determine if kinase insert domain/vascular endothelial growth factor receptor 2 (KDR/VEGFR2) genetic variation was associated with the development of ovarian hyperstimulation syndrome (OHSS) in patients undergoing controlled ovarian hyperstimulation (COH).MethodsThis was a case–control study of 174 patients who underwent controlled ovarian stimulation. Patient blood samples were genotyped for single nucleotide polymorphisms (SNPs) spanning the KDR locus. OHSS development, clinical outcome variables, SNP and haplotype frequencies were compared between control (n = 155) and OHSS (n = 19) groups.ResultsPatients who developed OHSS had significantly higher response markers (estradiol levels of the day of hCG administration, number of follicles developed, number of eggs retrieved) than control patients. When adjusted for age and self-identified race, the rs2305945 G/T genotype was associated (P = 0.027) with a decreased risk (OR = 0.30; 95% CI = 0.10, 0.93) of developing OHSS using an overdominant model. The rs2305945 G/T variant was also associated with decreased COH response (number of follicles, number of eggs retrieved) in an overdominant model. The rs2305948, rs1870378, rs2305945 (C-T-G) haplotype was associated with both decreased COH response and OHSS risk (unadjusted OR = 0.10; 95% CI = 0.01, 0.80, P = 0.031).ConclusionsThe KDR receptor is believed to play a central role OHSS development and is a target for pharmacological prevention of OHSS. These results indicate that genetic variation in the KDR gene may impact individual risk of developing OHSS from COH. In addition, the rs2305948 SNP and C-T-G haplotype might serve as potential biomarkers for poor ovarian response to COH.

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“…Primary risk factors suggested in the literature include polycystic ovarian syndrome, young age, low body weight, a high antral follicle count, a high serum concentration of anti-Müllerian hormone, use of gonadotropin releasing hormone (GnRH) analogues in a long protocol, higher doses of exogenous gonadotropins, and human chorionic gonadotropin (hCG) to trigger final follicular maturation [9,[12][13][14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Pre-hCG variables associated with occurrence of ascites in IVF/ICSI patients at moderate risk of developing OHSS: A pilot investigation

Sánchez¹,

Broberg²,

Pettersson³

et al. 2013

OJOG

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Factors associated with ovarian hyperstimulation syndrome (OHSS) and its effect on assisted reproductive technology (ART) treatment and outcome

Cited by 106 publications

References 34 publications

Clinical Utility of Measurement of Anti-Müllerian Hormone in Reproductive Endocrinology

Clinical Utility of Measurement of Anti-Müllerian Hormone in Reproductive Endocrinology

Kinase insert domain receptor/vascular endothelial growth factor receptor 2 (KDR) genetic variation is associated with ovarian hyperstimulation syndrome

Pre-hCG variables associated with occurrence of ascites in IVF/ICSI patients at moderate risk of developing OHSS: A pilot investigation

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