Human Reproduction, Vol. 10, No. 4, pp. 811-814, 1995
© 1995 European Society of Human Reproduction and Embryology
research-article |
Endocrinology: Predictive value of serum oestradiol concentrations and oocyte number in severe ovarian hyperstimulation syndrome
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, University of Southern California, Los Angeles County Women and Children's Hospital Los Angeles, CA, USA
Correspondence: 1To whom correspondence should be addressed at: Center for Human Reproduction, 750 North Orleans, Chicago, IL 60610, USA
Ovarian hyperstimulation syndrome (OHSS) is a serious complication of gonadotrophin usage but it is difficult to accurately predict its occurrence. Previous investigators have identified the combination of high oestradiol concentrations and oocyte number as being predictive in 80% of cases. In this study we sought to identify the incidence of severe OHSS in patients with high oestradiol concentrations and large numbers of oocytes and to evaluate the importance of pregnancy in the development of OHSS. Between 1990 and 1993, we studied 139 cycles using two assisted reproductive techniques [oocyte donor, n =72; in-vitro fertilization (IVF), n = 67] in which either oestradiol (>4000 pg/ml), oocyte number (>25), or both were elevated. OHSS was diagnosed by standard criteria. There were no cases of severe OHSS in the oocyte donor group and six in the IVF group. Among 10 patients with oestradiol concentration >6000 pg/ml and >30 oocytes, only one had OHSS (10%). The relative risk of OHSS with pregnancy was 12 (confidence interval 2.18–66.14). We conclude that the risk of OHSS even at high levels of stimulation is lower than previously believed. Secondly, donors have a very low risk of OHSS, probably because of the absence of pregnancy. As such, cryopreservation of all oocytes in IVF cycles is a reasonable alternative to cycle cancellation or use of adjunctive medication.
Key words: oestradiol/oocyte number/ovarian hyperstimulation syndrome/pregnancy risk factors
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  T.-H. Lee, C.-H. Liu, C.-C. Huang, Y.-L. Wu, Y.-T. Shih, H.-N. Ho, Y.-S. Yang, and M.-S. Lee Serum anti-mullerian hormone and estradiol levels as predictors of ovarian hyperstimulation syndrome in assisted reproduction technology cycles Hum. Reprod., January 1, 2008; 23(1): 160 - 167. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. L. Gustofson, J. H. Segars, and F. W. Larsen Ganirelix acetate causes a rapid reduction in estradiol levels without adversely affecting oocyte maturation in women pretreated with leuprolide acetate who are at risk of ovarian hyperstimulation syndrome Hum. Reprod., November 1, 2006; 21(11): 2830 - 2837. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Orvieto Can we eliminate severe ovarian hyperstimulation syndrome? Hum. Reprod., February 1, 2005; 20(2): 320 - 322. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Taieb, C. Benattar, R. Diop, A. S. Birr, and A. Lindenbaum Use of the Architect-i2000 Estradiol Immunoassay during in Vitro Fertilization Clin. Chem., January 1, 2003; 49(1): 183 - 186. [Full Text] [PDF]
|
|
|
|
|
|
T. Papageorgiou, J. Guibert, F. Goffinet, C. Patrat, Y. Fulla, Y. Janssens, and J.-R. Zorn Percentile curves of serum estradiol levels during controlled ovarian stimulation in 905 cycles stimulated with recombinant FSH show that high estradiol is not detrimental to IVF outcome Hum. Reprod., November 1, 2002; 17(11): 2846 - 2850. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P.E. Egbase, M.A. Sharhan, P. Berlingieri, and J.G. Grudzinskas Serum oestradiol and progesterone concentrations during prolonged coasting in 15 women at risk of ovarian hyperstimulation syndrome following ovarian stimulation for assisted reproduction treatment Hum. Reprod., October 1, 2000; 15(10): 2082 - 2086. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Khalaf, N. Elkington, H. Anderson, A. Taylor, and P. Braude Ovarian hyperstimulation syndrome and its effect on renal function in a renal transplant patient undergoing IVF treatment: Case report Hum. Reprod., June 1, 2000; 15(6): 1275 - 1277. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C.-D. Chen, H.-F. Chen, H.-F. Lu, S.-U. Chen, H.-N. Ho, and Y.-S. Yang Value of serum and follicular fluid cytokine profile in the prediction of moderate to severe ovarian hyperstimulation syndrome Hum. Reprod., May 1, 2000; 15(5): 1037 - 1042. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Enskog, L. Nilsson, and M. Brannstrom Peripheral blood concentrations of inhibin B are elevated during gonadotrophin stimulation in patients who later develop ovarian OHSS and inhibin A concentrations are elevated after OHSS onset Hum. Reprod., March 1, 2000; 15(3): 532 - 538. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R.S. Mathur and J.M. Jenkins Severe OHSS: Patients should be allowed to weigh the morbidity of OHSS against the benefits of parenthood Hum. Reprod., September 1, 1999; 14(9): 2183a - 2185a. [Full Text] [PDF]
|
|
|
|
|
|
F. Dancoine, G. Couplet, J. Buvat, C. Guittard, G. Marcolin, and J.-C. Fourlinnie Analytical and clinical evaluation of the Immulite(R) estradiol assay in serum from patients undergoing in vitro fertilization: estradiol increase in mature follicles Clin. Chem., July 1, 1997; 43(7): 1165 - 1171. [Abstract] [Full Text] [PDF]
|
|