Human Reproduction, Vol 12, 1573-1576, Copyright © 1997 by Oxford University Press
JT Queenan Jr, LL Veeck, JP Toner, S Oehninger and SJ Muasher
In-vitro fertilization patients (n = 15) at risk of ovarian
hyperstimulation syndrome (OHSS) (oestradiol > or =4500 pg/ml on the day
of human chorionic gonadotrophin administration and 25 or more follicles of
intermediate or large size) underwent aspiration of all follicles and
cryopreservation of all fertilized oocytes at the pronuclear stage.
Patients were monitored for up to 2 weeks post- retrieval. Subsequent
transfer of cryopreserved-thawed embryos was performed in programmed cycles
using exogenous oestrogen and progesterone for endometrial preparation. Two
patients (13%) developed OHSS necessitating hospitalization and vaginal
aspiration of ascitic fluid. Two other patients (13%) developed moderate
OHSS requiring ascitic fluid vaginal aspiration in the office setting, with
dramatic improvement of the condition. Subsequent transfer of
cryopreserved- thawed embryos yielded a clinical pregnancy rate of 58% per
transfer and ongoing or delivery rates of 42 and 67% per transfer and per
patient respectively. By eliminating pregnancy potential with
cryopreservation of all prezygotes and examining the pregnancy potential
with subsequent cryopreserved-thawed transfers, it is concluded that OHSS
is reduced, but not eliminated for patients at risk. Subsequent transfer of
cryopreserved-thawed prezygotes in a programmed cycle with exogenous
steroids yields an excellent pregnancy rate.
ARTICLES
Cryopreservation of all prezygotes in patients at risk of severe hyperstimulation does not eliminate the syndrome, but the chances of pregnancy are excellent with subsequent frozen-thaw transfers
The Jones Institute for Reproductive Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk 23507, USA.
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