Human Reproduction, Vol. 17, No. 12, 3027-3032,
December 2002
© 2002 European Society of Human Reproduction and Embryology
COCHRANE REVIEW |
Intravenous albumin for preventing severe ovarian hyperstimulation syndrome: a Cochrane review
1 The Egyptian IVF–ET Center, Maadi, Cairo & Cairo University, Department of Obstetrics and Gynecology and 2 Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Fertility, Academisch Ziekenhuis Maastricht, The Netherlands
BACKGROUND: The effectiveness of human albumin administration in prevention of severe ovarian hyperstimulation syndrome (OHSS) was reviewed using the Cochrane Menstrual Disorders and Subfertility Group literature search strategy. METHODS: Only randomized controlled trials (RCT) comparing the effect of human albumin with placebo or no treatment were included in this review. Seven RCT were identified, five of which met our inclusion criteria and enrolled 378 women (193 in the albumin-treated group and 185 in the control group). Trials under consideration were evaluated for methodological quality and appropriateness for inclusion without consideration of their results. The five included trials were single-centre parallel RCT. Relevant data were extracted independently by two reviewers using the standardized data extraction sheet. Validity was assessed in terms of method of randomization, completeness of follow-up, presence or absence of crossover and co-intervention. RESULTS: There was significant reduction in severe OHSS on administration of human albumin [odds ratio (OR): 0.28; 95% confidence interval (95% CI) 0.11–0.73]. Relative risk was 0.35 (95% CI 0.14–0.87) and absolute risk reduction was 5.5. For every 18 women at risk of severe OHSS, albumin infusion will save one more case. There was no evidence of an increase in the pregnancy rate [OR 1.09 (95% CI 0.65–1.83)]. CONCLUSIONS: This Cochrane review shows a clear benefit from administration of i.v. albumin at the time of oocyte retrieval in prevention of severe OHSS in high-risk cases. Whether the number needed to treat would justify the routine use of albumin infusion in cases at risk of severe OHSS needs to be judged by clinical decision-makers.
Key words: database review/intravenous albumin/OHSS/prevention/randomized controlled trials
3 To whom correspondence should be addressed at: The Egyptian IVF-ET Center, 3 Street 161, Hadayek El-Maadi, Cairo 11431, Egypt. E-mail: ivf{at}link.net
This paper is based on a Cochrane review published in The Cochrane Library, issue 3, 2002 (see www.CochraneLibrary.net for information) with permission from The Cochrane Collaboration and Update Software. Cochrane reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and The Cochrane Library should be consulted for the most recent version of the review.
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