Oocyte number as a predictor for ovarian hyperstimulation syndrome and live birth: an analysis of 256,381 in vitro fertilization cycles

2014 ◽  
Vol 101 (4) ◽  
pp. 967-973 ◽  
Author(s):  
Ryan G. Steward ◽  
Lan Lan ◽  
Anish A. Shah ◽  
Jason S. Yeh ◽  
Thomas M. Price ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Live Birth ◽  
Ovarian Hyperstimulation Syndrome ◽  
Ovarian Hyperstimulation ◽  
Vitro Fertilization ◽  
Oocyte Number

scholarly journals A Mutation in the Follicle-Stimulating Hormone Receptor as a Cause of Familial Spontaneous Ovarian Hyperstimulation Syndrome

2004 ◽  
Vol 89 (4) ◽  
pp. 1255-1258 ◽  
Author(s):  
Lucia Montanelli ◽  
Anne Delbaere ◽  
Costantino Di Carlo ◽  
Carmine Nappi ◽  
Guillaume Smits ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Ovarian Hyperstimulation Syndrome ◽  
Follicle Stimulating Hormone ◽  
High Sensitivity ◽  
Ovarian Hyperstimulation ◽  
Satisfactory Explanation ◽  
Vitro Fertilization ◽  
Increased Sensitivity ◽  
Stimulation Of

Abstract Ovarian hyperstimulation syndrome (OHSS) occurs mainly after excessive stimulation of the ovaries by exogenous gonadotropins administrated in the context of in vitro fertilization procedures (iatrogenic OHSS). Recently, spontaneous and recurrent occurrence of the disease (spontaneous OHSS) was shown in two families to be caused by mutations affecting the follitropin receptor (FSHr). The two mutant FSHr (T449I, D567N) harbor aminoacid substitutions in the serpentine portion of the receptor and display abnormally high sensitivity to the pregnancy hormone hCG, thus providing a satisfactory explanation to the phenotype. In addition, mutant D567N showed also increased sensitivity to thyrotopin (TSH) and displayed increase in basal (ligand-independent) activity. In this report, we describe a new familial case of recurrent OHSS. The affected women were heterozygous for a different mutation involving codon 449, where an alanine was substituted for threonine. Similar to D567N, the T449A FSHr mutant shows an increase of its sensitivity to both hCG and TSH, together with an increase in basal activity. Together with the two previous studies, this report shows that inappropriate stimulation of the FSHr by hCG is a cause of spontaneous OHSS.

scholarly journals Reproductive Outcomes of Women with Polycystic Ovarian Syndrome Following In-Vitro Fertilization — A Meta-Analysis and Systematic Review

2019 ◽  
Vol 01 (04) ◽  
pp. 193-201
Author(s):  
I-Ferne Tan ◽  
Audrey J. R. Lim ◽  
Inthrani R. Indran ◽  
Michael S. Kramer ◽  
Eu-Leong Yong
Keyword(s):  
Live Birth ◽  
Ovarian Hyperstimulation Syndrome ◽  
Birth Rate ◽  
Meta Analysis ◽  
Live Birth Rate ◽  
Ovarian Hyperstimulation ◽  
Vitro Fertilization ◽  
Ivf Outcomes ◽  
Ovarian Syndrome

Background: Polycystic ovarian syndrome (PCOS) is a common cause of infertility in women. In-vitro fertilization (IVF) is required in 20–30% of women with PCOS trying to conceive. This is associated with increased risk of multiple gestation and ovarian hyperstimulation syndrome. Improvements in IVF techniques, safety standards, and the increased use of frozen embryos in recent years have lead to improved outcomes for women with PCOS. We performed a systematic review and meta-analysis to compare these outcomes with women without PCOS. Search Methods: A search of PubMed, EMBASE, the Cochrane Central Register of clinical trials, and Scopus databases for all articles published until November 16th, 2017 identified 21 studies comparing IVF outcomes in PCOS and non-PCOS women. Inclusion criteria were Rotterdam criteria PCOS, comparable IVF regimes, immediate IVF outcomes, and pregnancy outcomes. Studies were excluded if the control group included any PCOS criteria, donor oocytes, or in-vitro maturation. Outcomes: No difference was observed in live birth rate per cycle in women with vs. without PCOS (RR [Formula: see text] 1.01 [0.89, 1.16]; [Formula: see text] 82%), but the live birth rate per first cycle in PCOS cycles (RR [Formula: see text] 0.93 [0.88, 0.99]) was slightly lower. There was also no difference in the clinical pregnancy rate (RR 1.02 [0.89, 1.17]) or biochemical pregnancy rate (RR 1.03 [0.99, 1.08]) observed between the two groups. PCOS was associated with a significantly higher number of oocytes retrieved (mean difference [Formula: see text] 3.6; 95% CI [2.8, 4.4]), risk of miscarriage (RR 2.90 [2.09, 4.02]), and risk of ovarian hyperstimulation syndrome (RR 3.42 [2.28, 5.13]) per cycle. Conclusion: Despite a widespread perception of poor reproductive potential, women with PCOS experience IVF outcomes similar to those without PCOS. Although there is a slightly lower live birth rate during their first stimulation cycle, success rates are similar after multiple cycles. PCOS is associated with a higher risk of ovarian hyperstimulation syndrome. Further studies are required to mitigate this risk.

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