Odds of ovarian hyperstimulation syndrome (OHSS) – time for reassessment

Mocanu, Edgar; Redmond, Marie Louise; Hennelly, Bernadette; Collins, Claire; Harrison, Robert F.

doi:10.1080/14647270701194143

Cited by 48 publications

(28 citation statements)

References 24 publications

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“…The laboratory procedure planned was IVF. The couple had one first cycle of treatment using the long down-regulation GnRH-a protocol described elsewhere [2]. Due to ovarian overresponse and to prevent late (pregnancy related) ovarian hyperstimulation syndrome (OHSS) a ''freeze all'' was recommended and five good quality zygotes were cryopreserved on day 3 following transvaginal oocyte recovery.…”

Section: Case Reportmentioning

confidence: 99%

First Irish birth following IVF therapy using antagonist protocol

et al. 2009

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Section: Case Reportmentioning

confidence: 99%

First Irish birth following IVF therapy using antagonist protocol

et al. 2009

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“…The incidence of hospitalization is 1.8% and the mortality rate is low with an estimated incidence at 1:400 000 to 1:500 000 3,4 .…”

Section: Introductionmentioning

confidence: 99%

Using Anti-Müllerian Hormone and Serum Estradiol to Predict Ovarian Hyperstimulation Syndrome in Patients Using Antagonist Protocol During IVF/ICSI Cycles

2017

Evidence Based Women's Health Journal

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Objectives: To investigate the ability of Anti-Müllerian hormone (AMH) and estradiol (E2) to predict OHSS in women using the GnRH antagonist protocol while undergoing invitro-fertilization (IVF) or intra-cytoplasmic sperm injection (ICSI). Study design: Retrospective analysis of women who had performed IVF/ICSI at assisted conception unit of Kasr Alainy university hospital over a period of 3 years. Patients and Methods: Basal serum AMH, estradiol (E2) level on the day of ovulation trigger and OHSS, among various other parameters were recorded and analyzed. Results: Thirty cases of OHSS (8.54%) were identified. There was no statistical difference in incidence of OHSS among age (p=0.976), FSH (p=0.286), LH (p=0.932), TSH (p=0.277), and prolactin (p=0.283), however, AMH (p=0.04), BMI (p=0.012), AFC (p< 0.001), and E2 before trigger (p<0.001) were significant. The overall clinical pregnancy rate was 27.35 % (n=96). The receiver operator analysis curve had a cut-off value of 4.45ng/ml (80%, sensitivity & 56% specificity). The area under the curve (AUC) was 0.661 with 95% confidence interval (CI) (0.548-0.775) (p=0.003). While for E2 the cut-off value was 4459 pg/ml with 76.7% sensitivity and 55.7% specificity), AUC 0.673 95% (CI) (0.554-0.791) (p=0.002). Combining both AMH ≥ 4.45ng/ml and E2 ≥4459 pg/ml had odds ratio 4.302 (95% CI) (1.795-10.304), relative risk (RR) 0.891 with 95%CI (0.832-0.954) (p<0.001). Conclusion: AMH and serum E2 before trigger are not highly accurate tests alone for the prediction of OHSS. When basal serum AMH was ≥4.45ng/ml and E2 ≥ 4459 pg/ml, the patient was at 4 fold increased risk of developing OHSS.

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“…The clinical presentation can vary from mild to severe life-threatening symptoms requiring hospital admission in 1.9% of cases. 4 …”

Section: 5005/jp-journals-10016-1065mentioning

confidence: 99%