2013
DOI: 10.1093/humrep/det124
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Severe early ovarian hyperstimulation syndrome following GnRH agonist trigger with the addition of 1500 IU hCG

Abstract: Although the GnRH agonist plus 1500 IU hCG luteal rescue protocol significantly decreases the risk of severe OHSS, this life threatening complication can still occur in high-risk patients. It would be prudent to avoid hCG luteal rescue and freeze all embryos for future transfer in such women particularly when there are ≥18 follicles with 10-14 mm diameters even with few larger follicles.

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Cited by 138 publications
(107 citation statements)
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“…GnRH agonist ovulation triggering has contributed to the further reduction of severe OHSS [37,10,15,14] and, in conjunction with elective cryopreservation of all viable embryos, is considered to be the safest way to avoid OHSS after OS for IVF [38,12,14]. In view of this, elective cryopreservation of embryos has been proposed for women undergoing IVF/ICSI who develop ≥18 follicles with a diameter of at least 10-14 mm [39] to minimize the risk of the development of severe OHSS. OHSS in a GnRH agonist triggered Bfreeze-all^has been, until now, such a unique event that some have considered it to be likely limited to women genetically prone to develop this complication [19].…”
Section: Discussionmentioning
confidence: 99%
“…GnRH agonist ovulation triggering has contributed to the further reduction of severe OHSS [37,10,15,14] and, in conjunction with elective cryopreservation of all viable embryos, is considered to be the safest way to avoid OHSS after OS for IVF [38,12,14]. In view of this, elective cryopreservation of embryos has been proposed for women undergoing IVF/ICSI who develop ≥18 follicles with a diameter of at least 10-14 mm [39] to minimize the risk of the development of severe OHSS. OHSS in a GnRH agonist triggered Bfreeze-all^has been, until now, such a unique event that some have considered it to be likely limited to women genetically prone to develop this complication [19].…”
Section: Discussionmentioning
confidence: 99%
“…one hour after oocyte retrieval [6,7], was demonstrated to rescue the luteal phase, resulting in a reproductive outcome comparable with that of HCG triggering, and with no increased risk of OHSS [8]. However, when applied to patients at high-risk to develop severe OHSS, 26 % developed severe early OHSS requiring ascites drainage and hospitalization [9]. A figure that is comparable to the acceptable 20 % prevalence of severe OHSS in ostensibly high risk patients [10].…”
Section: Introductionmentioning
confidence: 99%
“…IVM has a range of applications [2]. It can prevent ovarian hyperstimulation syndrome (OHSS), resolving cases in which the combined use of GnRH antagonist to suppress endogenous gonadotropin release and GnRH agonist to trigger final maturation is not sufficient to completely avoid the risk of development of the syndrome [3,4].…”
Section: Introductionmentioning
confidence: 99%