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<0.001), AMH (OR, 1.259; 95% CI, 1.206–1.315; P<0.001), E2 value on the day of hCG injection (OR, 1.122; 95% CI, 1.021–1.253; P<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.

Recurrent spontaneous ovarian hyperstimulation syndrome associated with polycystic ovary syndrome

1995 ◽  
Vol 9 (4) ◽  
pp. 313-315 ◽  
Author(s):  
Y. Zalel ◽  
R. Orvieto ◽  
Z. Ben-Rafael ◽  
R. Homburg ◽  
O. Fisher ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Ovarian Hyperstimulation Syndrome ◽  
Polycystic Ovary ◽  
Ovarian Hyperstimulation ◽  
Ovary Syndrome

Induction of ovulation with letrozole in women with polycystic ovary syndrome

GYNECOLOGY ◽  
2017 ◽  
Vol 19 (6) ◽  
pp. 19-23
Author(s):  
G E Chernukha ◽  
E K Kaprina ◽  
A A Naidukova
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Ovarian Hyperstimulation Syndrome ◽  
Polycystic Ovary ◽  
Multiple Pregnancy ◽  
Ovarian Hyperstimulation ◽  
Ovary Syndrome ◽  
Good Tolerability ◽  
Induction Of Ovulation ◽  
Effect Of Therapy ◽  
Anovulatory Infertility

The aim of the study was to evaluate the effectiveness of the use of letrozole as an inducer of ovulation in women with polycystic ovary syndrome (PCOS) and anovulatory infertility and to determine possible clinical and laboratory predictors of the effect of therapy. Materials and methods: 61 women with anovulatory infertility and PCOS (mean age 28.5 ± 3.3 years, mean body mass index - BMI 21.8 ± 2.7 kg / m2) were included in the study. In order to induce ovulation, the patient received letrozole at a dose of 2.5-5 mg / day from day 3 to 7 of the menstrual cycle under the control of folliculometry, ultrasound m / pelvis on the 20-24 day cycle and the level of progesterone in the blood. Results: the frequency of ovulation per cycle was 77.2% (146/189), 98.4% for women, 24.9% for conception (47/189), 77% for women (47/61) , in 6 (12.8%) women the pregnancy was biochemical, in 1 (2.1%) ectopic, multiple pregnancy took place in 2 (5%) women with progressive uterine pregnancy, spontaneous abortion in the period up to 12 weeks of gestation occurred in 5 (12.5%) women, there was no case of ovarian hyperstimulation syndrome or other side effects. Comparative analysis revealed higher levels of BMI, the percentage of total adipose tissue by densitometry, and the number of antral follicles in the volume of the ovaries in the group with no pregnancy. Conclusion: letrozole is an effective medication for induction of ovulation and pregnancy in the treatment of infertility in patients with PCOS, characterized by good tolerability, low risk of multiple pregnancies and the absence of cases of ovarian hyperstimulation syndrome.

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