Follicular aspiration does not protect against the development of ovarian hyperstimulation syndrome
Clinical Assisted Reproduction
The purpose of this study was to determine the effect of follicular aspiration on the incidence of ovarian hyperstimulation syndrome (OHSS).
A retrospective study was done on 219 IVF cycles that proceeded to follicular aspiration (group A) and they were compared with 189 cycles of ovulation induction for non-IVF cycles (group B). We compared the incidence of OHSS in regularly ovulating patients (subgroups A1 and B1) and anovulatory patients (subgroups A2 and B2) in both groups.
The study took place at The Egyptian IVF-ET Center.
Participants were 319 infertility patients.
Ovulation was induced and follicles were aspirated.
Main Outcome Measures
The incidences of moderate and severe OHSS were the main outcome measures.
The incidence of OHSS in group B was significantly higher than that in group A (P =0.016). There was no significant difference in the incidence of OHSS between subgroup A1 and subgroup B1 or between subgroup A2 and subgroup B2.
Follicular aspiration had no effect on the incidence of OHSS. In contrast, the higher incidence of OHSS in group B was related to the higher incidence of anovulatory infertility.
Key wordsovarian hyperstimulation syndrome follicular aspiration gonadotropin releasing hormone agonist analogue
Porter RN, Smith W, Craft IL, Abdulwhid NA, Jacobs HS: Induction of ovulation for in vitro fertilization using Buserelin and gonadotropins. Lancet 1984;2:1284–1285Google Scholar
Fleming R, Haxton MJ, Hamilton MPR, McCune GS, Black WP, Macnaughton MC, Coutts JRT: Successful treatment of infertile women with oligomenorrhea using a combination of an LH-RH agonist and exogenous gonadotropins. Br J Obstet Gynecol 1985;92:369–374Google Scholar
Aboulghar MA, Mansour RT, Serour GI: Successful treatment of long term unexplained infertility with gonadotropin-releasing hormone agonist analogue and human menopausal gonadotropin. Acta Obstet Gynecol Scand 1990;69:313–315PubMedGoogle Scholar
Golan A, Ron-El R, Herman A, Weinraub Z, Soffer Y, Caspi E: Ovarian hyperstimulation syndrome following D-Trp-6 luteinizing hormone-releasing hormone microcapsules and menotropins for in vitro fertilization. Fertil Steril 1988;50:912–916PubMedGoogle Scholar
Caspi E, Ron-El R, Golan A, Naechum H, Herman A, Soffer Y, Weinraub Z: Results of in vitro fertilization and embryo transfer by combined long-acting gonadotropin-releasing hormone analog D-Trp-6-luteinizing hormone-releasing hormone and gonadotropins. Fertil Steril 1989;51:95–99PubMedGoogle Scholar
Forman RG, Frydman R, Egan D, Ross C, Barlow D: Severe ovarian hyperstimulation syndrome using agonists of gonadotropin-releasing hormone for in vitro fertilization: A European series and a proposal for prevention. Fertil Steril 1990;53:502–509PubMedGoogle Scholar
Golan A, Ron-El R, Herman A, Soffer Y, Weinraub Z, Caspi E: Ovarian hyperstimulation syndrome: An update review. Obstet Gynecol Surv 1989;44:430–439PubMedGoogle Scholar
Rabinowitz R, Laufer N, Lewin A: Rate of ovarian hyperstimulation syndrome after high-dose HMG for induction of ovulation in IVF cycles. ESHRE third meeting. Cambridge, UK, June 1987Google Scholar
Belaisch-Allart J, Belaisch J, Hazout A, Testart J, Frydman R: Selective oocyte retrieval: A new approach to ovarian hyperstimulation. Fertil Steril 1988;50:654–656PubMedGoogle Scholar
Rabau E, Serr DM, David A: Human menopausal gonadotropins for anovulation and sterility. Am J Obstet Gynecol 1967;96:92–98Google Scholar
Schenker JG, Weinstein D: Ovarian hyperstimulation syndrome: A current survey. Fertil Steril 1978;30:255–268PubMedGoogle Scholar
Landis RJ, Heyman ER, Koch GG: Average association in 3-way contingency tables: A review and discussion and alternative tests. Int Stat Rev 1978;46:237–254Google Scholar
Aboulghar MA, Mansour RT, Serour GI, Amin Y: Ultrasonically guided vaginal aspiration of ascites in the treatment of severe ovarian hyperstimulation syndrome. Fertil Steril 1990;53:933–935PubMedGoogle Scholar
Friedman CI, Schmidt GE, Chang FE, Kim MH: Severe ovarian hyperstimulation following follicular aspiration. Am J Obstet Gynecol 1984;150:436–437PubMedGoogle Scholar
Smitz J, Camus M, Devroey P, Erad P, Wisanto A, Van Steirteghem AC: Incidence of severe ovarian hyperstimulation syndrome after GnRH agonist/HMG superovulation for in vitro fertilization. Hum Reprod 1990;5:933–937PubMedGoogle Scholar
Bider D, Menashe Y, Oelsner G, Serr DM, Maschiach S, Ben-Rafael Z: Ovarian hyperstimulation syndrome due to exogenous gonadotropin administration. Acta Obstet Gynecol Scand 1989;68:511–514PubMedGoogle Scholar
Check JH, Wu CH, Gocial B, Adelson HG: Severe ovarian hyperstimulation syndrome from treatment with urinary follicle-stimulating hormone: Two cases. Fertil Steril 1985;43:317–319PubMedGoogle Scholar
Charbonnel B, Krempf M, Blanchard P, Dano F, Delage C: Induction of ovulation in polycystic ovary syndrome with a combination of luteinizing hormone-releasing hormone analog and exogenous gonadotropins. Fertile Steril 1987;47:920–924Google Scholar
Tulandi T, McInnes RA, Arronet GH: Ovarian hyperstimulation syndrome following ovulation induction with HMG. Int J Fertil 1984;29:113–117PubMedGoogle Scholar
Tyler E: Treatment of anovulation with menotropins. JAMA 1984;205:16–19Google Scholar
Varma TR, Patel RH: Ovarian hyperstimulation syndrome: A case history and review. Acta Obstet Gynecol Scand 1988;67:579–584PubMedGoogle Scholar
Blankstein J, Shalev J, Saadon T: Ovarian hyperstimulation syndrome: Prediction by number and size of preovulatory ovarian follicles. Fertil Steril 1987;47:597–602PubMedGoogle Scholar
Haning RV Jr, Austin CW, Carlson IH, Kuzma DL, Shapiro SS, Zweibel WJ: Plasma estrodiol is superior to ultrasound and urinary estrodiol glucuronide as a predictor of ovarian hyperstimulation during induction of ovulation with menotropins. Fertil Steril 1983;40:31–36PubMedGoogle Scholar
Asch RH, Li HP, Balmaceda JP, Weckstein LN, Stone SC: Severe ovarian hyperstimulation syndrome in assisted reproductive technology: Definition of high risk group. Hum Reprod 1991;6:1395–1399PubMedGoogle Scholar
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