Human Reproduction, Vol 12, 2599-2602, Copyright © 1997 by Oxford University Press
MA Graf, R Fischer, OG Naether, V Baukloh, J Tafel and M Nuckel
Prophylactic infusion of human serum albumin can reduce or mitigate severe
ovarian hyperstimulation syndrome (OHSS) in patients at high risk.
Recently, concern has been expressed in the lay press regarding the
potential viral transmissions with blood constituents. Hence, we looked for
a safe non-biological substitute with comparable physical properties in
order to cope with this concern. One hundred patients of our in-vitro
fertilization (IVF) programme with oestradiol serum concentrations > or
= 11010 pmol/l on the day of human chorionic gonadotrophin injection and/or
> or = 20 oocytes retrieved and/or previous severe OHSS were infused
with 1000 ml 6% hydroxyaethyl starch solution at the time of oocyte
collection and 500 ml 48 h later. A total of 82 IVF patients at risk
without prophylactic infusions during the preceding years served as
controls. Both groups were identical according to patient's age, body mass
index, androgen concentrations, peak oestradiol concentrations, number of
retrieved oocytes, fertilization and pregnancy rates. There were seven
cases of severe OHSS in untreated patients and two cases in the treatment
group (P = 0.08). In moderate OHSS a significant difference became obvious
with only ten cases in the treatment group and 32 cases in the control
group (P < 0.00001). Hydroxyaethyl starch solution seems to be an
effective and economic alternative in reducing severe and moderate OHSS
during IVF treatment.
ARTICLES
Reduced incidence of ovarian hyperstimulation syndrome by prophylactic infusion of hydroxyaethyl starch solution in an in-vitro fertilization programme
Endokrinologische Praxisgemeinschaft Hamburg, IVF unit, Germany.
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