A new approach to the management of patients at risk of ovarian hyperstimulation in an in-vitro fertilization programme.

Abstract

In this study, we report an alternative method of management of patients at a potential risk of ovarian hyperstimulation syndrome (OHSS) in an in-vitro fertilization (IVF) programme, by the use of gonadotrophin releasing hormone analogue (GnRHa). Thirty eight women considered at risk of this syndrome, having serum oestradiol greater than 4000 pg/ml following ovarian stimulation, received a GnRHa nasal spray for induction of the preovulatory endogenous luteinizing hormone surge for follicular maturation prior to oocyte recovery. Oocyte recovery (mean oocytes per cycle 18.60 +/- 4.79; range 15-35) and IVF were successfully completed in 27 cycles. Twenty six women had embryos replaced and 11 pregnancies occurred (28.9% per operation, 42.3% per replacement cycle). None of the patients developed OHSS. Where there is a risk of OHSS, the use of GnRHa to induce the preovulatory surge of endogenous luteinizing hormone for final follicular maturation provides a successful and more economical alternative to cancellation of cycles.

• Authors: D A Imoedemhe, R C Chan, A B Sigue, E L Pacpaco, A B Olazo
• Journal: Human reproduction (Oxford, England) (Hum Reprod) Vol. 6 Issue 8 Pg. 1088-91 (Sep 1991) ISSN: 0268-1161 [Print] England
• PMID: 1806566 (Publication Type: Journal Article)

Chemical References

• Gonadotropin-Releasing Hormone
• Progesterone
• Estradiol
• Luteinizing Hormone
• Follicle Stimulating Hormone

Topics

• Adult
• Embryo Transfer
• Estradiol (blood)
• Female
• Fertilization in Vitro
• Follicle Stimulating Hormone (metabolism)
• Gonadotropin-Releasing Hormone (analogs & derivatives, therapeutic use)
• Humans
• Luteinizing Hormone (metabolism)
• Oocytes (cytology)
• Ovarian Hyperstimulation Syndrome (blood, etiology, prevention & control)
• Ovulation Induction (adverse effects, methods)
• Progesterone (blood)
• Risk Factors