Ovarian hyperstimulation syndrome

Avecillas, Jaime F.; Falcone, Tommaso; Arroliga, Alejandro C.

doi:10.1016/j.ccc.2004.05.003

Cited by 28 publications

(33 citation statements)

References 55 publications

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“…Currently, IVF programs achieve superovulation by administering an expensive array of menotropin and gonadotropin hormone treatments over an extended period of time. The hormone treatment approach is effective in stimulating ovaries, yet it is quite costly and it is associated with some health risks, most notably ovarian hyperstimulation syndrome (50). It may be possible to replace the hormone-mediated superovulation approach with an Ab approach particularly one with an inherent or bioengineered short half-life.…”

Section: Discussionmentioning

confidence: 99%

Autoimmune Targeted Disruption of the Pituitary-Ovarian Axis Causes Premature Ovarian Failure

Altuntas

Johnson

Tuohy

2006

The Journal of Immunology

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Premature ovarian failure (POF) is characterized by amenorrhea and high serum levels of follicle-stimulating hormone (FSH). POF causes female infertility and represents a substantial women’s health risk affecting 1% of women by age 40. Although ovarian autoimmunity has been associated with POF, the identity of ovarian Ags recognized is unknown. In this study, we show that autoimmune-targeted disruption of the pituitary-ovarian axis leads to POF. Immunization of SWXJ female mice with the p215–234 peptide derived from mouse inhibin-α activates CD4+ T cells and induces experimental autoimmune oophoritis with a unique biphasic phenotype characterized by an early stage of enhanced fertility followed by a delayed stage of POF. Affected mice show high serum levels of inhibin-α-neutralizing Abs that prevent inhibin-mediated down-regulation of activin-induced pituitary FSH release. The loss of activin/FSH down-regulation leads to prolonged metestrus-diestrus, superovulation, increased numbers of mature follicles, increased offspring, accelerated depletion of primordial follicles, and ultimately premature infertility. Thus, inhibin-α-targeted experimental autoimmune oophoritis is initiated by CD4+ Th1 T cells that stimulate B cells to produce inhibin-α-neutralizing Abs directly capable of mediating POF and transferring disease into naive recipients. Our inhibin-α autoimmune model of POF shows how premature infertility may develop in the context of elevated FSH levels thereby closely mimicking the hallmark features of human POF.

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Section: Discussionmentioning

confidence: 99%

Autoimmune Targeted Disruption of the Pituitary-Ovarian Axis Causes Premature Ovarian Failure

Altuntas

Johnson

Tuohy

2006

The Journal of Immunology

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“…Lo anterior, asociado a embarazo e hiperestimulación ovárica, incrementa los riesgos de torsión anexial, según diversos autores. Ovarios aumentados de volumen, quísticos, producto de inducción de ovulación, a los cuales se agrega el síndrome de hiperestimulación ová-rica, tienen mayor riesgo de torsión (4,8,10). El SHO complica el diagnóstico inicial, ya que estas pacientes se presentan con un abdomen distendido y sensible, secundario a ovarios aumentados de volumen.…”

Section: Discussionunclassified

“…La incidencia de torsión anexial después de fertilización in vitro (FIV), varía entre 0,08% y 0,13%, según distintos estudios (5-7). Sin embargo, en mujeres con torsión anexial, la asociación con SHO fluctúa entre 1% -33% (4,8,9). Al lograrse un embarazo con hiperestimulación ovárica y más aún en la presencia de SHO, los quistes ová-ricos persisten y esto prolonga el período de riesgo de torsión anexial (10).…”

Section: Introductionunclassified

Manejo Laparoscópico De Quistes Ováricos Complicados O Persistentes Durante El Embarazo

Albornoz

et al. 2009

Rev. chil. obstet. ginecol.

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RESUMENAntecedentes: El incremento en el hallazgo de quistes anexiales durante el embarazo sería el mayor uso de técnicas de reproducción asistida con hiperestimulación ovárica controlada. La complicación más frecuente sigue siendo la torsión anexial. Objetivo: Revisar el manejo de quistes anexiales complicados o persistentes, durante el embarazo, con resolución laparoscópica. Método: Revisión retrospectiva de 9 pacientes consecutivas, ingresadas al Departamento de Obstetricia y Ginecología Clínica Las Condes. Resultados: La edad gestacional de ingreso fue entre 5+5 y 27 semanas. Cinco casos fueron producto de fertilización asistida y cuatro espontáneos. Ocho (85,6%) embarazadas, ingresaron por dolor abdominal agudo. Otro caso ingresó a cirugía electiva por quiste ovárico persistente. Los quistes tenían entre 6 y 13 cm. En 5 se realizó sólo destorsión ovárica, en 1 ooforectomía y en 1 quistectomía. Se realizó punción, destorsión y fijación a ligamento útero ovárico, bilateral, en la otra paciente. Se registró un caso de fiebre en el postoperatorio. El alta hospitalaria fue a las 48 horas en 6 (67%), a las 72 en 2 y a las 96 en 1. El estudio biópsico diferido en 3 pacientes demostró: 1 quiste seroso paratubario, 1 quiste luteínico parcialmente hemorrágico y 1 infarto anexial. Todos los embarazos evolucionaron normalmente. Conclusión: Nuestra experiencia confirma que en el embarazo la laparoscopía es una buena opción al requerir una cirugía por quiste anexial complicado o persistente. PALABRAS CLAVE: Torsión anexial, laparoscopia, hiperestimulación ovárica, embarazo SUMMARYBackground: Recent reviews show an increase in the finding of adnexal cysts during pregnancy. One reason could be the use of assisted reproductive techniques with controlled ovarian hyperstimulation. Objective: To review the experience in managing via laparoscopy complicated or persistent adnexal cysts during pregnancy. Method: Retrospective review of 9 consecutive patients, admitted at the Department of Obstetrics and Gynecology, Clinica Las Condes. Results: The gestational age was between 5+5 and 27 weeks. Five were the product of assisted fertilization and four spontaneous. Eight (85.6%) pregnant women were admitted by emergency room because of acute abdominal pain and another one went through elective surgery for persistent ovarian cyst. Preoperative diagnosis of the 8 patients admitted by emergency: adnexal cyst complicated with torsion in 6 (1 adnexal infarction) and 2 cases of acute abdomen. The cysts were between 6 and 13 cm. Type of surgery: in 5, only detorsion; ovarian oophorectomy in 1 and cystectomy in one. Puncture, detorsion and bilateral fixation of uterine ovarian ligament, in another patient. One case required conversion to laparotomy with adnexectomy. Postoperative fever was observed in one patient. Discharge was at 48 hrs

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“…Human chronic gonadotropin (hCG) was Dear Sir, Ovarian hyperstimulation syndrome (OHSS) is a potentially lethal complication of ovulation induction [1,2] . OHSS can represent electrolyte imbalance, neurohormonal and hemodynamic changes, pulmonary manifestations, liver dysfunction, hypoglobulinemia, febrile morbidity and thromboembolic phenomena.…”

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confidence: 99%

Multiple Cerebral Infarctions Associated with Polycystic Ovaries and Ovarian Hyperstimulation Syndrome

Song¹,

Lee

2007

Eur Neurol

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Ovarian hyperstimulation syndrome

Cited by 28 publications

References 55 publications

Autoimmune Targeted Disruption of the Pituitary-Ovarian Axis Causes Premature Ovarian Failure

Autoimmune Targeted Disruption of the Pituitary-Ovarian Axis Causes Premature Ovarian Failure

Manejo Laparoscópico De Quistes Ováricos Complicados O Persistentes Durante El Embarazo

Multiple Cerebral Infarctions Associated with Polycystic Ovaries and Ovarian Hyperstimulation Syndrome

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