Is It Possible to Prevent Ovarian Hyperstimulation Syndrome by Gonadotropin-Releasing Hormone Agonist Triggering and Modified Luteal Support in Patients With Polycystic Ovarian Morphology?

Autor: Dilek Incesu, Necati Ozcimen, Mert Küçük, Ali Sami Gurbuz, Sezen Bozkurt Koseoglu, Rüya Deveer
Rok vydání: 2016
Předmět:
Zdroj: Journal of Clinical Medicine Research
ISSN: 1918-3011
1918-3003
DOI: 10.14740/jocmr2500w
Popis: Background: Gonadotropin-releasing hormone (GnRH) agonist triggering plus 1,500 IU human chorionic gonadotropin (hCG) supplementation protocol was previously claimed effective in reducing the ovarian hyperstimulation syndrome (OHSS) incidence in high responders. Methods: This retrospective study included women with polycystic ovarian (PCO) morphology who were at high risk of OHSS and were given the GnRH agonist trigger plus hCG luteal support protocol in a single center. Results: The mean peak estradiol level was 5,336 ± 2,341 (1,187 - 19,746) pg/mL. The mean number of follicles > 12 mm on the day of trigger was 22 ± 7 (9 - 51). A total of 88 cycles were undertaken. Sixty-three (71.5%) women underwent fresh embryo transfer. Fresh embryo transfer was canceled in 21 (23.8%) and embryo transfer was canceled in four (4.5%) women. The overall clinical pregnancy rate was 46.4% per started cycle. A total of 12 (13.6%) patients developed OHSS. “Freeze-all” policy did not attenuate OHSS in four patients, and three of these patients developed OHSS despite 1,500 IU hCG was not administered. Conclusion: We conclude that OHSS may still occur with the use of a GnRH agonist trigger combined with low-dose hCG supplementation protocol in women with polycystic ovary syndrome (PCOS) or PCO morphology. Furthermore, we also conclude that “freeze-all” policy also will not completely eliminate OHSS development in high-risk women. J Clin Med Res. 2016;8(5):396-401 doi: http://dx.doi.org/10.14740/jocmr2500w
Databáze: OpenAIRE
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