Intravenous albumin prevents moderate—severe ovarian hyperstimulation in in-vitro fertilization patients: a prospective, randomized and controlled study

Administration of Intravenous Albumin around the Time of Oocyte Retrieval Reduces Pregnancy Rate without Preventing Ovarian Hyperstimulation Syndrome: A Systematic Review and Meta-Analysis

“…The mechanisms for the putative effect of albumin in preventing OHSS have been proposed: albumin is thought to prevent the development of OHSS by increasing plasma oncotic pressure and binding of the vasoactive mediators of ovarian origin, such as VEGF [10,12,17] , but this has not been substantiated. Because capillary permeability is compromised in patients with OHSS, the duration of the oncotic effect would be insufficient to prevent OHSS [2] .…”

“…All studies used serum level of E 2 and/or number of follicles or oocytes as the basic risk factor of OHSS; however, their cutoff values varied across the 9 studies. Diagnosis of severe OHSS was done according to the criteria of Schenker (1978) in 4 of the 9 trials [9,12,15,16] , whereas others [10,18,19] used the criteria of Navot (1988) or Golan (1989).…”

“…Subsequently, 2 studies [9,10] also demonstrated that prophylactic IV administration of 25% albumin (20-50 g) at the time of oocyte retrieval significantly reduced the risk of OHSS when the E 2 levels are markedly elevated or there is a history of a previous episode of OHSS. However, a number of clinical trials showing the ineffectiveness of IV albumin have been conducted subsequently [11][12][13][14][15] ; in contrast, 1 study reported the beneficial effect of IV albumin for preventing OHSS [16] .…”

“…Although studies of its efficacy have had mixed results, a meta-analysis including 5 randomized controlled trials (RCTs) [9,10,12,15,16] denoted that prophylactic albumin administration significantly reduced the risk of developing OHSS [odds ratio (OR) = 0.28, 95% confidence interval (CI) = 0.11-0.73] [17] . Since then, further RCTs have evaluated the effectiveness of albumin infusion on the day of oocyte retrieval and consistently reported that this intervention is not a useful means of preventing the development of OHSS [18,19] .…”

Comparison of cabergoline and intravenous albumin in the prevention of ovarian hyperstimulation syndrome: a randomized clinical trial

“…human albumin (HA) use for the prevention of OHSS by Asch et al until now, there have been conflicting findings. Some studies suggested a role for albumin in the prevention of OHSS [2][3][4]. However, in several recent studies the effect of HA was similar to a placebo [5,6] and less than other preventive drugs [7][8][9].…”