scholarly journals Insulin Resistance and Free Androgen as Predictors for Ovarian Hyperstimulation Syndrome in Non-PCOS Women

2020 ◽  
Vol 52 (02) ◽  
pp. 104-108
Author(s):  
Roshan Nikbakht ◽  
Mahvash Zargar ◽  
Farideh Moramezi ◽  
Mahnaz Ziafat ◽  
Hamed Tabesh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Insulin Resistance ◽  
Ovarian Hyperstimulation Syndrome ◽  
Polycystic Ovary ◽  
Antral Follicle ◽  
Controlled Ovarian Hyperstimulation ◽  
Multivariable Logistic Regression Analysis ◽  
Ovarian Hyperstimulation ◽  
Free Androgen Index ◽  
Preovulatory Follicles

AbstractWe evaluated the effect of insulin resistance and free androgen index (FAI) in non-PCOS (polycystic ovary syndrome) infertile women following controlled ovarian hyperstimulation. A prospective study was done on 144 infertile non-PCOS women with regular menstrual cycle. At first, insulin resistance (IR), free androgen index (FAI), PCOM (polycystic ovary morphology), AFC (antral follicle count), and AMH (anti-Müllerian hormone) were assessed. The patients underwent assisted reproductive technology (ART), and then preovulatory follicles and oocytes retrieved were recorded. The variables of the study were compared between two groups of patients with ovarian hyperstimulation syndrome (OHSS) (n=66) and non-OHSS patients (n=78). Of the 9 variables: BMI, HOMA-IR, FAI, AFC, AMH, PCOM, and preovulatory follicles were risk factors, while the age and retrieved oocytes were not. The 7 variables that showed significance in the univariate analyses were determined as independent variables included in the multivariable logistic regression analysis, as a result, a total of 5 risk factors, BMI, HOMA-IR, FAI, PCOM, and preovulatory follicles entered the equation. The maximum contribution was HOMA-IR followed by PCOM, FAI, preovulatory follicles and BMI. Patients with OHSS had higher chance to have ovaries with polycystic morphology (74%), about three times more than patients who did not develop OHSS (29%) (p<0.001). The best cut-points for IR, FAI, AFC, AMH, and preovulatry follicles were 2.36, 3.9, 8, 3.3 ng/ml, and 10, respectively. Patients with a higher value of BMI, FAI, HOMA-IR, and preovulatory follicles and the presence of PCOM are more likely to develop OHSS, which are not confined to PCOS patients.

scholarly journals Insulin resistance and free androgen index correlate with the outcome of controlled ovarian hyperstimulation in non-PCOS women undergoing IVF

2009 ◽  
Vol 25 (2) ◽  
pp. 504-509 ◽  
Author(s):  
E.H. Dickerson ◽  
L.W. Cho ◽  
S.D. Maguiness ◽  
S.L. Killick ◽  
J. Robinson ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Controlled Ovarian Hyperstimulation ◽  
Ovarian Hyperstimulation ◽  
Free Androgen Index

scholarly journals Factors Associated with Ovarian Hyperstimulation Syndrome (OHSS) Severity in Women With Polycystic Ovary Syndrome Undergoing IVF/ICSI

2021 ◽  
Vol 11 ◽  
Author(s):  
Bo Sun ◽  
Yujia Ma ◽  
Lu Li ◽  
Linli Hu ◽  
Fang Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Polycystic Ovary Syndrome ◽  
Strong Correlation ◽  
Ovarian Hyperstimulation Syndrome ◽  
Polycystic Ovary ◽  
Elevated Serum ◽  
Ovarian Hyperstimulation ◽  
Ovary Syndrome ◽  
Cutoff Value ◽  
Basal Serum

IntroductionAge, polycystic ovary syndrome (PCOS), low body mass index (BMI), high antral follicle count (AFC), increased anti-Muller hormone (AMH) levels, and elevated serum estradiol (E2) concentrations are risk factors for ovarian hyperstimulation syndrome (OHSS). However, data on the relationship between risk factors and OHSS severity in patients with PCOS are rare.ObjectiveThis retrospective study examined the risk factors for OHSS and their effect on OHSS severity in patients with PCOS undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI).MethodThe records of 2,699 women were reviewed and included in this study. These women were diagnosed with PCOS during their first IVF/ICSI cycle between January 2010 and December 2017. We analyzed the association between each of the interrogated risk factors (including female age, BMI, AFC, basal serum E2, and the number of oocytes retrieved) and OHSS. The effects of each risk factor on OHSS severity were further explored. Logistic regression was performed as part of the above analysis.ResultsOf the 2,699 women with PCOS who underwent assisted reproductive technology (ART), 75.2% had a normal response to controlled ovarian hyperstimulation (COH), while 24.8% developed OHSS. All OHSS patients were younger and had lower BMIs and basal serum follicle-stimulating hormone (FSH) and E2 levels but higher AFCs than those in the normal group. AFC demonstrated a strong correlation with OHSS, with a cutoff value of 24 in patients with PCOS. A total of 19.5% of the patients had mild OHSS, while 80.5% had moderate OHSS. Compared with those in the moderate OHSS group, those in the mild OHSS group were older and had higher basal serum FSH levels and lower serum E2 and T levels. However, BMI and AFC were not different between the mild and moderate OHSS groups. Basal serum E2 showed a strong correlation with OHSS severity, with a cutoff value of 37.94 pg/ml.ConclusionsAFC is a strong marker of OHSS, and basal serum E2 is the best predictor of OHSS severity in women with PCOS undergoing IVF treatment.

scholarly journals Nomogram Model to Predict the Probability of Ovarian Hyperstimulation Syndrome in the Treatment of Patients With Polycystic Ovary Syndrome

2021 ◽  
Vol 12 ◽  
Author(s):  
Fei Li ◽  
Ying Chen ◽  
Aiqin Niu ◽  
Yajing He ◽  
Ying Yan
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Polycystic Ovary Syndrome ◽  
Ovarian Hyperstimulation Syndrome ◽  
Polycystic Ovary ◽  
Receiver Operating Curve ◽  
Ovarian Hyperstimulation ◽  
Ovary Syndrome ◽  
Modeling Group ◽  
Independent Risk Factors

ObjectiveThe objective of this study was to explore the risk factors of ovarian hyperstimulation syndrome (OHSS) in patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) and to establish a nomogram model evaluate the probability of OHSS in PCOS patients.MethodsWe retrospectively analyzed clinical data from 4,351 patients with PCOS receiving IVF/ICSI in our reproductive medical center. The clinical cases were randomly divided into a modeling group (3,231 cases) and a verification group (1,120 cases) according to a ratio of about 3:1. The independent risk factors correlation with the occurrence of OHSS was identified by logistic regression analysis. Based on the selected independent risk factors and correlated regression coefficients, we established a nomogram model to predict the probability of OHSS in PCOS patients, and the predictive accuracy of the model was measured using the area under the receiver operating curve (AUC).ResultsUnivariate and multivariate logistic regression analyses showed that FSH (OR, 0.901; 95% CI, 0.847–0.958; P&lt;0.001), AMH (OR, 1.259; 95% CI, 1.206–1.315; P&lt;0.001), E2 value on the day of hCG injection (OR, 1.122; 95% CI, 1.021–1.253; P&lt;0.001), total dosage of Gn used (OR, 1.010; 95% CI, 1.002–1.016; P=0.041), and follicle number on the day of hCG injection (OR, 0.134; 95% CI, 1.020–1.261; P=0.020) are the independent risk factors for OHSS in PCOS patients. The AUC of the modeling group is 0.827 (95% CI, 0.795–0.859), and the AUC of the verification group is 0.757 (95% CI, 0.733–0.782).ConclusionThe newly established nomogram model has proven to be a novel tool that can effectively, easily, and intuitively predict the probability of OHSS in the patients with PCOS, by which the clinician can set up a better clinical management strategies for conducting a precise personal therapy.

scholarly journals Prevention of Ovarian Hyperstimulation Syndrome: A Review

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Vinayak Smith ◽  
Tiki Osianlis ◽  
Beverley Vollenhoven
Keyword(s):  
Gnrh Agonist ◽  
Ovulation Induction ◽  
Ovarian Hyperstimulation Syndrome ◽  
Best Practice ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Ovarian Hyperstimulation ◽  
Management Options ◽  
Broad Perspective ◽  
Single Method

The following review aims to examine the available evidence to guide best practice in preventing ovarian hyperstimulation syndrome (OHSS). As it stands, there is no single method to completely prevent OHSS. There seems to be a benefit, however, in categorizing women based on their risk of OHSS and individualizing treatments to curtail their chances of developing the syndrome. At present, both Anti-Müllerian Hormone and the antral follicle count seem to be promising in this regard. Both available and upcoming therapies are also reviewed to give a broad perspective to clinicians with regard to management options. At present, we recommend the use of a “step-up” regimen for ovulation induction, adjunct metformin utilization, utilizing a GnRH agonist as an ovulation trigger, and cabergoline usage. A summary of recommendations is also made available for ease of clinical application. In addition, areas for potential research are also identified where relevant.

scholarly journals Serum Sex Hormone Binding Globulin Concentration as a Predictor of Ovarian Response During Controlled Ovarian Hyperstimulation

2021 ◽  
Vol 8 ◽  
Author(s):  
Junyu Zhai ◽  
Shang Li ◽  
Yinci Zhu ◽  
Yun Sun ◽  
Zi-Jiang Chen ◽  
...  
Keyword(s):  
Polycystic Ovary ◽  
Ovarian Response ◽  
Controlled Ovarian Hyperstimulation ◽  
Sex Hormone ◽  
Sex Hormone Binding Globulin ◽  
Study Cohort ◽  
Ovarian Hyperstimulation ◽  
Hormone Binding ◽  
Serum Samples ◽  
The Relationship

Purpose: Serum concentrations of sex hormone binding globulin (SHBG), a glycated homodimeric plasma transport protein, correlate positively with the total number of follicles in women with infertility. However, the relationship between serum SHBG concentrations and the ovarian response during controlled ovarian hyperstimulation (COH) and whether this relationship differs between women with and without polycystic ovary syndrome (PCOS) remains unclear.Methods: The study cohort included 120 participants (60 non-PCOS and 60 PCOS) undergoing in vitro fertilization. Serum samples were collected from each participant every 2–3 days during the COH cycle. The concentrations of serum SHBG and other sex hormones were determined to investigate the relationship between serum SHBG concentrations and the ovarian response in women with and without PCOS.Results: We found that the serum SHBG concentration was positively correlated with the ovarian response in non-PCOS patients but not in PCOS patients.Conclusion: The serum SHBG concentration may be clinically useful as a predictor of the ovarian response during COH in patients without PCOS.

scholarly journals Antral follicle count and anti-Müllerian hormone level as predictors of ovarian hyperstimulation syndrome in women with polycystic ovarian syndrome undergoing controlled ovarian stimulation

2021 ◽  
Vol 21 (86) ◽  
pp. e200-e205
Author(s):  
Rubina Izhar ◽  
◽  
Samia Husain ◽  
Muhammad Ahmad Tahir ◽  
Mauzma Kausar ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Ovarian Stimulation ◽  
Ovarian Hyperstimulation Syndrome ◽  
Polycystic Ovarian Syndrome ◽  
Hormone Level ◽  
Antral Follicle ◽  
Antral Follicle Count ◽  
Controlled Ovarian Stimulation ◽  
Ovarian Hyperstimulation ◽  
Ovarian Syndrome

Aim: To compare the rate of ovarian hyperstimulation syndrome in women with and without polycystic ovarian syndrome, and to determine the cut-off for the antral follicle count and the anti-Müllerian hormone level predictive of ovarian hyperstimulation syndrome in both groups. Methods: This was a prospective cohort study conducted in women aged 20–35 years who were undergoing controlled ovarian stimulation. The women were divided into those with polycystic ovarian syndrome and the controls on the basis of the Rotterdam criteria. The outcome of stimulation was recorded, and the ovarian response markers were compared in both groups. Results: Among 689 women included in the study, 276 (40.1%) had polycystic ovarian syndrome, and 476 (59.9%) were used as the controls. Ovarian hyperstimulation syndrome occurred in 19.6% of the cases, and in 7.7% of the controls (p <0.001). The conception rate was greater in the group of cases (52.5% vs. 16.5%, p = 0.001). Among the cases, the sensitivity and specificity for the prediction of hyper-response were 94.4% and 97.3% for AFC, and 92.6% and 93.7% for the anti-Müllerian hormone, at the cut-off values of ≥18 and ≥6.425 ng/ml, respectively. Among the controls, the sensitivity and specificity for the prediction of hyper-response were 93.8% and 97.1% for the antral follicle count, and 93.6% and 94.5% for the anti-Müllerian hormone, at the cut-off values of ≥10 and ≥3.95 ng/ml, respectively. Conclusion: Group-specific values should be used to identify and counsel women undergoing controlled ovarian stimulation. In light of available evidence, gynaecologists should be trained to perform ultrasound evaluation, determine the antral follicle count of their patients, and offer them appropriate counselling.

Sign in / Sign up

Export Citation Format

Share Document