scholarly journals Ovarian Hyperstimulation Syndrome Ratio And In Vitro Fertilization Success With Gonadotrphine Releasing Hormone Trigger And 1500 IU Human Chorionic Gonadotrophine For Luteal Support

2018 ◽  
Vol 2 (1) ◽  
Keyword(s):  
At Risk ◽  
Pregnancy Rate ◽  
Ovarian Hyperstimulation Syndrome ◽  
Trigger Factor ◽  
In Vitro Fertilisation ◽  
Ovarian Hyperstimulation ◽  
Luteal Support ◽  
Releasing Hormone ◽  
Patients At Risk

Intraduction: Ovarian hyperstimulation syndrome (OHSS) is very serius complication of in vitro fertilisation (IVF) treatments. Human chorionic gonadotrophine (hCG) is the trigger factor of the syndrome. Gonadotrophine releasing hormone agonist (GnRHa) can use instead of hCG for triggering the ovulation. Matherial and Methods: This study aims to evaluate the effects of ovulation triggering with Gonadotrophine Releasing Hormone Agonists (GnRHa) on ovarian hyperstimulation syndrome (OHSS) rates and pregnancy success in patients at risk of OHSS. 51 cycles were evaluated in 50 women. Gonadotrophine (Gn) was applied to all patients with a flexible GnRHa protocol. To trigger ovulation, 0.2 mg triptorelin was applied when the estradiol level was 3500-7000 pg/mL and/or when at least 18 follicles were determined at ≥10mm. Oocyte Pick-Up (OPU) was performed 35 hours after the triptorelin injection. Within 1 hour of OPU, luteal support with 1500 IU hCG was administered to the patients and on the night of OPU, vaginal progesterone and oral estrogen were started. Results: OHSS was determined in 5 cycles (9.8%), and 4 of them (7.8%) were early OHSS. Embryo transfer was applied in 49 cycles. The pregnancy rate was determined as 44.9%, clinical pregnancy rate as 26.5%, continuing pregnancy rate as 24.4% and the abortus rate as 2%. Conclusion: GnRHa triggering applied before treatment to patients at risk of early OHSS does not completely eliminate the risk of OHSS. Nevertheless, this protocol improved treatment results without increasing the rates of severe OHSS.

scholarly journals Luteal Support and Risk of Ovarian Hyperstimulation in Assisted Reproduction (A Review)

2020 ◽  
Vol 27 (6) ◽  
pp. 136-148
Author(s):  
V. A. Krutova ◽  
A. A. Baklakova
Keyword(s):  
Embryo Transfer ◽  
Intracytoplasmic Sperm Injection ◽  
Luteal Phase ◽  
Gonadotropin Releasing Hormone ◽  
In Vitro Fertilisation ◽  
Ovarian Hyperstimulation ◽  
Luteal Support ◽  
Releasing Hormone ◽  
Gonadotropin Releasing Hormone Agonist

Background. Gonadotropin-releasing hormone agonist as an ovulation trigger effectively reduces the ovarian hyperstimulation risk in in vitro fertilisation protocols, at the same time requiring an effective luteal phase support in embryo transfer cycles.Objectives. A review of modern approaches to luteal support after the ovulation trigger switch in in vitro fertilisation/intracytoplasmic sperm injection protocols; assessment of feasibility and safety of gonadotropin-releasing hormone agonist in the post-transfer period.Methods. Literature sources were mined in the PubMed, eLibrary, Web of Science, Cochrane Library, Cyberleninka databases at a depth of 10 years. The query keywords were: gonadotropin-releasing hormone agonist, luteal phase support, ovulation trigger, in vitro fertilisation, ovarian hyperstimulation syndrome.Results. The review included 35 records selected from the 96 analysed total. The analysis reveals a sensible efficiency of gonadotropin-releasing hormone agonist for the luteal phase support, improved success of in vitro fertilisation/intracytoplasmic sperm injection and embryo transfer strategies, improved pregnancy outcomes. Microdosing of chorionic gonadotropin to supplement standard progesterone luteal support also improves the pregnancy outcome rate in assisted reproduction, however, at the risk of late ovarian hyperstimulation syndrome and should be applied with caution.Conclusion. Administration of gonadotropin-releasing hormone agonist for luteal support may improve pregnancy outcomes in in vitro fertilisation/intracytoplasmic sperm injection protocols in patients with the ovarian hyperstimulation risk after the ovulation trigger switch. Nevertheless, further research is necessary into the efficacy and safety of gonadotropin-releasing hormone agonist for luteal support in embryo transfer cycles.

scholarly journals A Case with Severe Endometriosis, Ovarian Hyperstimulation Syndrome, and Isolated Unilateral Pleural Effusion after IVF

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Negjyp Sopa ◽  
Elisabeth Clare Larsen ◽  
Anders Nyboe Andersen
Keyword(s):  
Pleural Effusion ◽  
Ovarian Hyperstimulation Syndrome ◽  
Common Finding ◽  
Ovarian Hyperstimulation ◽  
Pleural Effusions ◽  
Luteal Support ◽  
Vitro Fertilization ◽  
Fluid Production ◽  
The Right

We present a very rare case of right-sided isolated pleural effusion in a patient with severe endometriosis who, in relation to in vitro fertilization (IVF), developed ovarian hyperstimulation syndrome (OHSS). Earlier laparotomy showed grade IV endometriosis including endometriotic implants of the diaphragm. The patient had no known risk factors for OHSS and only a moderate number of oocytes aspirated. She received, however, repeated hCG injections for luteal support. The patient did not achieve pregnancy but was hospitalized due to pain in the right side of the chest and dyspnoea. A chest computed tomography (CT) showed a pleural effusion on the right side. Total of 1000 ml of pleural fluid was drained after a single thoracentesis. After three days, the symptoms and fluid production ceased. Ascites is a common finding in OHSS, but pleural effusions are rare. Further, isolated pleural effusions have not previously been described in a patient with endometriosis. We suggest that the repeated hCG injections induced effusions from the endometriotic lesions at the diaphragm and as a consequence this patient developed isolated hydrothorax.

scholarly journals A Case of Isolated Hemorrhagic Pleural Effusion: A Rare Presentation of Ovarian Hyperstimulation Syndrome (OHSS) – A Case Report

2020 ◽  
pp. 23-24
Author(s):  
Sailaja Kambhampati ◽  
M C V Sreekar
Keyword(s):  
Ovarian Hyperstimulation Syndrome ◽  
Fatal Case ◽  
In Vitro Fertilisation ◽  
Ovarian Hyperstimulation ◽  
Pleural Effusions ◽  
Rare Presentation ◽  
Hemorrhagic Pleural Effusion ◽  
Life Threatening

Introduction: Ovarian hyperstimulation syndrome (OHSS) is a rare,life-threatening serious complication of ovulation induction with human chorionic gonadotropin (hCG). (4) 3% of patients undergoing IVF (in vitro fertilisation) develop OHSS. But radiologically evident pleural effusions develop only in 1% among which hemorrhagic effusions are very rare (1). Pleural effusions due to OHSS are usually associated with ascites. Isolated unilateral pleural effusions are uncommon. (2,3) The syndrome occurs in the luteal phase or during early part of pregnancy. The syndrome was first described in 1941 and the first fatal case of OHSS with renal failure and death was described in 1951.

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