Ovarian Hyperstimulation Syndrome: The Best Approaches for Preven-tion and Treatment: A Mini-Review
| Autor: | Alessandro Fasciani, Mauro Costa, Massimo Manno, Francesco Tomei |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
medicine.medical_specialty
business.industry media_common.quotation_subject Obstetrics and Gynecology Ovarian hyperstimulation syndrome Progesterone secretion medicine.disease Bioinformatics Polycystic ovary Metformin Human chorionic gonadotropin Vascular endothelial growth factor chemistry.chemical_compound Endocrinology chemistry Cabergoline Internal medicine medicine business Ovulation medicine.drug media_common |
| Zdroj: | Current Women's Health Reviews. 3:49-54 |
| ISSN: | 1573-4048 |
| DOI: | 10.2174/157340407779941868 |
| Popis: | Ovarian hyperstimulation syndrome (OHSS) is the most serious iatrogenic disorder resulting from ovarian stimulation during assisted reproductive techniques (ARTs). It can result in renal failure, thromboembolic phenomena, adult respiratory distress syndrome and, occasionally, death. Almost all previous preventive strategies resulted ineffective. Vascular Endothelial Growth Factor (VEGF) plays a pivotal role in the pathophysiology of this syndrome so VEGF antagonism has been suggested for OHSS prevention. Since VEGF is also a physiological regulator of folliculogenesis, progesterone secretion and endometrial angiogenesis, its complete inactivation by monoclonal antibodies could produce potential undesirable effects. Administration of Human Chorionic Gonadotropin (HCG) stimulation of VEGF production is fatal for the developing of OHSS; the use of GnRH agonist instead of HCG for ovulation triggering, is a promising strategy. Recently dopamine D2 agonists have been shown to counteract VEGF induced vascular permeability. The lack of toxic or teratogenic effects could make cabergoline an effective and safe aetiological approach for OHSS prevention/treatment. A recent meta-analysis has indicated that the administration of metformin significantly prevents OHSS development in polycystic ovary syndrome, an high risk group. In the light of these new studies we believe that recent guidelines on OHSS prevention need a substantial revision. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|