Ovarian stimulation and liver dysfunction: Is a clinical relationship possible? A case of hepatic failure after repeated cycles of ovarian stimulation

Giugliano, Emilio; Cagnazzo, Elisa; Pansini, Giancarlo; Vesce, Fortunato; Marci, Roberto

doi:10.5653/cerm.2013.40.1.38

Cited by 4 publications

(5 citation statements)

References 17 publications

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“…18 Excessive ovarian stimulation may increase the risk of liver failure later in pregnancy, particularly as IVF is associated with increased risk of hypertensive disorders of pregnancy, for example haemolysis, elevated liver enzymes, and low platelet syndrome (HELLP). 19 In LT recipients, a few reports exist of successful IVF outcomes. [20][21][22][23] In this report, we describe the outcomes and impact of IVF in a range of presentations of liver disease.…”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of in vitro fertilisation in patients with chronic liver disease and liver transplantation recipients

Rahim

Theocharidou

Lau

et al. 2021

Journal of Hepatology

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Section: Introductionmentioning

confidence: 99%

Safety and efficacy of in vitro fertilisation in patients with chronic liver disease and liver transplantation recipients

Rahim

Theocharidou

Lau

et al. 2021

Journal of Hepatology

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“…The clinical importance for the measurements of the liver enzymes is of critical value to evaluate the effect of the treatments on general health. The previous reports indicated that repeated ovarian stimulation might deteriorate the hepatic functions, leading to liver failure [44]. There have been variations in ALT and AST activities due to animal physiological status.…”

Section: Discussionmentioning

confidence: 99%

Consequences of twinning induction to Noemi ewes by a recombinant human follicle-stimulating hormone compared with pituitary-derived porcine follicle-stimulating hormone on follicular dynamics, maternal biochemical attributes, and neonatal traits

et al. 2020

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Aim: The aim of this study was to investigate the effectiveness of using recombinant human follicle-stimulating hormone (FSH) compared with pituitary-derived porcine FSH given as one dose or multiple doses on the neonatal traits, follicular dynamics, and maternal blood biochemical constituents in Noemi ewes. Materials and Methods: A 3×2 factorial arrangement was designed utilizing 60 adults Noemi ewes to test the effects of using two sources of FSH (human vs. porcine) in addition to control, either given as a single total dose or six descending doses to provoke twinning. Six treatments (T) were tested (n=10 ewes/T). C1 and C6 served as control ewes given saline as one dose and six doses, respectively; H1 and H6 ewes were given human FSH as one and six doses; and P1 and P6 ewes were given porcine FSH similar to the above treatments. Saline and/or FSH administration were administered at days 8, 9, and 10 of the 10-day controlled internal drug release (CIDR) implant. At CIDR removal, fertile rams were used for natural mating. Blood samples for the assessment of serum metabolites were collected. Results: Twinning increased in FSH-treated ewes than control. However, giving FSH of either source as a single dose resulted in a higher incidence of stillbirths. Pregnancy rates were 30, 40, 50, 60, 70, and 80% in C1, C6, P1, P6, H1, and H6, respectively. Respective percent of ewes delivering twins/multiple birth was 0, 0, 80, 66.7, 71.4, and 87.5%. FSH of human source was more efficient for folliculogenesis than porcine FSH. Administration of FSH increased blood cholesterol, decreased high-density lipoprotein; however, low-density lipoprotein levels were not different than control. Moreover, an interaction (p<0.05) exists between source and type of FSH administration on blood glucose. Six doses of FSH elevated blood protein. Blood albumin decreased by porcine-FSH but not affected by human-FSH. Blood globulins were not different due to source of FSH, whereas giving FSH as six doses increased globulins than in single-dose protocol. Contrariwise, an interaction was found between source and type of FSH administration on elevating the activity of alanine aminotransferase and reducing the activity of aspartate aminotransferase. Conclusion: Administration of human FSH at 180 IU in six descending doses resulted in the best neonatal outcomes and maternal health in Noemi ewes.

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“…Despite the small number of reported cases, it seems that ICP recurrence during third trimester might be possible when it has already been developed during the first trimester, probably because during the third trimester estrogen levels rise again [ 37 ] and these women have a predisposition for ICP development [ 38 ]. ICP is associated with adverse pregnancy and perinatal outcomes such as preterm labor, fetal asphyxia, meconium-stained amniotic fluid, and stillbirth and with an increased risk of preeclampsia, especially among women with an early ICP manifestation and twin gestations [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Intrahepatic cholestasis of pregnancy after ovarian hyperstimulation syndrome with wild-type ABCB4 gene: a peculiar case and literature review

et al. 2023

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Background Intrahepatic cholestasis of pregnancy (ICP) in the first trimester occurring after ovarian hyperstimulation syndrome (OHSS) is a rare condition and few cases are reported in the literature. Hyperestrogenism may explain this problem in genetically predisposed women. The objective of this article is to report one of these rare cases and offer an overview of the other published cases. Case presentation We report a case of severe OHSS followed by ICP in the first trimester. The patient was admitted to the intensive care unit and was treated according to the guidelines for the management of OHSS. Moreover, the patient also received ursodeoxycholic acid for ICP, which brought to an improvement of her clinical conditions. The pregnancy continued without other complications until the 36th week of gestation, when the patient developed ICP in the third trimester and underwent cesarean section for increased bile acid levels and cardiotocographic (CTG) pathologic alterations. The newborn was a healthy baby weighing 2500 gr. We also reviewed other case reports published by other authors about this clinical condition. We present what is, to our knowledge, the first case of ICP developed in the first trimester of pregnancy after OHSS in which genetic polymorphisms of ABCB4 (MDR3) have been investigated. Conclusions ICP in the first trimester might be induced by elevated serum estrogen levels after OHSS in genetically predisposed women. In these women, it might be useful to check for genetic polymorphisms to know if they have a predisposition for ICP recurrence in the third trimester of pregnancy.

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Ovarian stimulation and liver dysfunction: Is a clinical relationship possible? A case of hepatic failure after repeated cycles of ovarian stimulation

Cited by 4 publications

References 17 publications

Safety and efficacy of in vitro fertilisation in patients with chronic liver disease and liver transplantation recipients

Safety and efficacy of in vitro fertilisation in patients with chronic liver disease and liver transplantation recipients

Consequences of twinning induction to Noemi ewes by a recombinant human follicle-stimulating hormone compared with pituitary-derived porcine follicle-stimulating hormone on follicular dynamics, maternal biochemical attributes, and neonatal traits

Intrahepatic cholestasis of pregnancy after ovarian hyperstimulation syndrome with wild-type ABCB4 gene: a peculiar case and literature review

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