Prediction of ovarian hyperstimulation syndrome. Challenging the estradiol mythos.
نویسنده
چکیده
Ovarian hyperstimulation syndrome (OHSS) is a serious and potentially life-threatening complication of ovulation induction. The syndrome almost always presents either after hCG administration in susceptible patients or during early pregnancy. Despite many years of clinical experience, the pathophysiology is poorly understood and there is no reliable test to predict patients who will subsequently develop severe OHSS. Nevertheless, excessive estradiol (E(2)) levels are commonly used as a predictor for the development of severe OHSS. The aim of this debate is to challenge this E(2) mythos by demonstrating the reported versatility in the chosen E(2) level in which patients develop OHSS; present pathophysiological evidence which paradoxically supports a preventive rather than a detrimental effect of E(2) against OHSS, followed by a possible explanation which may sort out the aforementioned chaos. Additional studies are required to elucidate the pathophysiology of OHSS which may ultimately lead to new strategies in the prediction, prevention and treatment of severe OHSS.
منابع مشابه
Cabergoline versus Coasting in the Prevention of Ovarian Hyperstimulation Syndrome and Assisted Reproductive Technologies Outcome in High Risk Patients
Background Coasting is the most common method used in the prevention of ovarian hyperstimulation syndrome (OHSS) acting through vascular endothelial growth factor (VEGF) reduction. However, the pregnancy rate is reported to fall with coasting when it takes more than three days. Recently lowdose cabergoline, a selective D2 dopamine receptor agonist has been proven to selectively reduce vascular ...
متن کاملCut-Off Levels of Anti-Mullerian Hormone for The Prediction of Ovarian Response, In Vitro Fertilization Outcome and Ovarian Hyperstimulation Syndrome
Background Evaluation of anti-mullerian hormone (AMH) cut-off levels in assisted reproductive technology (ART) as predictive factor for individualization of stimulation protocols and to avoid ovarian hyperstimulation syndrome (OHSS). MaterialsAndMethods In a retrospective study, 177 infertile patients were assessed for AMH in serum and follicular fluid (FF) on the day of follicular puncture (FP...
متن کاملPrediction of ovarian hyperstimulation syndrome (OHSS). Estradiol level has an important role in the prediction of OHSS.
The cascade of events that leads to the development of ovarian hyperstimulation syndrome (OHSS) is almost always accompanied by elevated estradiol (E(2)) levels. The role of estrogen level in OHSS has not been confirmed; however, it was shown repeatedly in the literature that elevated levels of E(2) constitute a risk for OHSS. Monitoring E(2) was found to be effective in reducing the incidence ...
متن کاملEffect of Low-dose Human Chorionic Gonadotropin on the Prevention of Ovarian Hyperstimulation Syndrome and in Vitro Fertilization Outcome
Background & aim: Ovarian hyperstimulation syndrome (OHSS) is a rare but most potentially life-threatening disorder in women under in vitro fertilization (IVF). This study aimed to determine the effect of low-dose human chorionic gonadotropin (hCG) on the prevention of OHSS and IVF outcome. Methods: This single-blind non-randomized clinical trial was performed from October 2008 to November 2012...
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ورودعنوان ژورنال:
- Human reproduction
دوره 18 4 شماره
صفحات -
تاریخ انتشار 2003