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Human Reproduction, Vol. 6, No. 5, pp. 665-669, 1991
© 1991 European Society of Human Reproduction and Embryology

other

Hormonal profiles and follicular growth in cycles with imminent ovarian hyperstimulation

O. Kushnir, Z. Ben-Rafael1, J. Shalev, S. Lipitz, D. Bider, S. Mashiach and J. Blankstein

Department of Obstetrics and Gynaecology, The Chaim Sheba Medical Centre 52621 Tel-Hashomer and The Sackler School of Medicine, Tel-Aviv University Israel

Correspondence: 1To whom correspondence should be addressed

Ovarian hyperstimulation syndrome is a common and serious complication of human menopausal gonadotrophin/human chorionic gonadotrophin treatment. We evaluated the changes in the pituitary and ovarian hormone profiles and ultrasonographic follicular regression in 12 patients in whom human menopausal gonadotrophin was discontinued due to ‘imminent’ ovarian hyperstimulation. Following discontinuation, three distinct periods were ovserved: (i) days 1–2, the levels of oestradiol, testosterone and prolactin, and the total number of follicles continued to rise; (ii) days 3–6, the levels of oestradiol, testosterone and prolactin declined sharply and the total number of follicles was reduced significantly, while the large and medium sized follicles continued to increase. Levels of follicle-stimulating hormone and luteinizing hormone gradually declined to reach their lowest levels by days 5–6 and then increased. (iii) Thereafter the number of follicles and steroid output declined to early follicular phase levels. We conclude that discontinuation of human menopausal gonadotrophin and withholding human chorionic gonadotrophin in cycles with laboratory signs of ‘imminent’ ovarian hyperstimulation syndrome, allows regression of the ovarian ultrasonographic finding and prevents the development of clinical symptoms. However, if rescue of the cycle is attempted, human chorionic gonadotrophin should be given during the first 4 days after discontinuation of stimulation.

Key words: hormonal profiles/ovarian hyperstimulation syndrome


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