The Prevention of Ovarian Hyperstimulation Syndrome

Corbett, Shannon; Shmorgun, Doron; Claman, Paul; Cheung, Anthony P.; Sierra, Sony; Carranza-Mamane, Belina; Case, Allison; Dwyer, CM; Graham, James R.; Havelock, Jon; Healey, Sarah; Hemmings, Robert; Liu, Kimberly; Motan, Tarek; Murdock, Ward; Smithson, David S.; Vause, Tannys; Wong, Benjamin; Gysler, Mathias

doi:10.1016/s1701-2163(15)30417-5

Cited by 64 publications

(35 citation statements)

References 54 publications

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“…Limited information is available on pregnancy rates post-treatment for breast cancer patients using each of the fertility options by age. As such, the team used the best available evidence from the Canadian Fertility and Andrology Society (CFAS) [39] and the literature [37,[40][41][42][65][66][67][68] to determine the estimated pregnancy success rates by age for wait and see, embryo cryopreservation, and ovarian suppression and had these rates confirmed by four reproductive specialists.…”

Section: Resultsmentioning

confidence: 99%

“…Our team reviewed the literature and consulted with content experts in oncology and fertility to identify the most up-to-date and applicable literature on fertility, pregnancy post-treatment, the health of children born to cancer survivors and using preserved embryos and eggs [32][33][34][35][36], the risk of infertility from cancer treatments [37,38], pregnancy success rates and risks for the fertility options [36,37,[39][40][41][42], and psychosocial aspects of fertility in survivorship [43,44]. In addition, information was gathered from organizations that provide credible information to patients (Canadian Cancer Society [45], Fertile Future [46], American Society for Reproductive Medicine [47], Breastcancer.org [48]) as well as the American Society of Clinical Oncology (ASCO) fertility guidelines from 2006 and 2013 [49,50].…”

Section: Development Processmentioning

confidence: 99%

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The "Begin Exploring Fertility Options, Risks and Expectations" (BEFORE) decision aid: development and alpha testing of a fertility tool for premenopausal breast cancer patients

Speller

Metcalfe

Kennedy

et al. 2019

BMC Med Inform Decis Mak

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Background: Premenopausal breast cancer patients are at risk of treatment-related infertility. Many patients do not receive sufficient fertility information before treatment. As such, our team developed and alpha tested the Begin Exploring Fertility Options, Risks, and Expectations decision aid (BEFORE DA). Methods: The BEFORE DA development process was guided by the International Patient Decision Aids Standards and the Ottawa Decision Support Framework. Our team used integrated knowledge translation by collaborating with multiple stakeholders throughout the development process including breast cancer survivors, multidisciplinary health care providers (HCPs), advocates, and cancer organization representatives. Based on previously conducted literature reviews and a needs assessment by our teamwe developed a paper prototype. The paper prototype was finalized at an engagement meeting with stakeholders and created into a graphically designed paper and mirrored online decision aid. Alpha testing was conducted with new and previously engaged stakeholders through a questionnaire, telephone interviews, or focus group. Iterative reviews followed each step in the development process to ensure a wide range of stakeholder input. Results: Our team developed an 18-page paper prototype containing information deemed valuable by stakeholders for fertility decision-making. The engagement meeting brought together 28 stakeholders to finalize the prototype. Alpha testing of the paper and online BEFORE DA occurred with 17 participants. Participants found the BEFORE DA usable, acceptable, and most provided enthusiastic support for its use with premenopausal breast cancer patients facing a fertility decision. Participants also identified areas for improvement including clarifying content/messages and modifying the design/photos. The final BEFORE DA is a 32-page paper and mirrored online decision aid (https:// fertilityaid.rethinkbreastcancer.com). The BEFORE DA includes information on fertility, fertility options before/after treatment, values clarification, question list, next steps, glossary and reference list, and tailored information on the cost of fertility preservation and additional resources by geographic location.

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Section: Resultsmentioning

confidence: 99%

Section: Development Processmentioning

confidence: 99%

The "Begin Exploring Fertility Options, Risks and Expectations" (BEFORE) decision aid: development and alpha testing of a fertility tool for premenopausal breast cancer patients

Speller

Metcalfe

Kennedy

et al. 2019

BMC Med Inform Decis Mak

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“…The use of metformin for the prevention of OHSS in patients with PCOS is also widely encouraged 10. Metformin inhibits the secretion of vasoactive mediators such as VEGF and thus reduces vascular permeability 11.…”

Section: Discussionmentioning

confidence: 99%

Multiorgan failure associated with severe ovarian hyperstimulation syndrome due to inadequate protocol optimisation: a rare but avoidable complication

2018

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Ovarian hyperstimulation syndrome (OHSS) is a well-recognised iatrogenic complication following controlled ovarian stimulation (COS). Mild to moderate cases are mostly managed conservatively. Severe cases of OHSS can be potentially fatal. For this reason, UK clinics providing licensed fertility treatment are obliged to follow Human Fertilisation and Embryology Authority guidelines for reporting severe incidents. We present an unusually severe complication of OHSS resulting in significant morbidity. A nulligravida woman aged 25, with a 4-year history of subfertility and multiple risk factors for the development of OHSS, underwent COS. Immediately following oocyte retrieval, the patient developed symptoms of early-onset severe OHSS. The subsequent clinical deterioration of the patient precipitated multiple organ failure, including renal and hepatic dysfunction. Despite supportive management in an intensive care unit, the patient required transfer to a tertiary liver centre for specialist treatment. OHSS is a preventable complication; therefore, such an uncommon presentation of the syndrome provides important clinical lessons to be discussed.

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“…Benzer şekilde rekombinan hCG, üriner hCG ve rekombinan LH uygulamalarının da OHSS riskini değiştirmediği saptanmıştır. 51 Antagonist protokollerde tetikleyici olarak agonist kullanmak OHSS riskini belli gruplarda azalmaktadır, bununla ilgili Kanada Jinekoloji ve Obstetrik Cemiyetinin önerisi bu protokolün aşa-ğıdaki iki durumdan birinde kullanılmasıdır: 52 …”

Section: Yöneti̇munclassified