Ovarian hyperstimulation syndrome after GnRH agonist trigger and rhCG luteal rescue protocol
Abstract
Ovarian hyperstimulation syndrome (OHSS) is a rare, but serious iatrogenic complication of In Vitro Fertilization treatments. Since 1943, when the first cases of OHSS were reported, strategies to prevent it have not been very successful. At present, the most used strategy to prevent OHSS is the “freeze-all strategy”, which consists in the utilization of a gonadotropin releasing hormone (GnRH) agonist trigger for oocytes maturation in a GnRH antagonist protocol, followed by cryopreservation of all embryos. In this paper, we present a case of a young woman who developed OHSS after GnRH agonist trigger followed by rhCG luteal rescue protocol. By reporting this case, we want to highlight the importance of OHSS prevention and patients selection for hCG luteal rescue protocol.
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OHSS, IVF, GnRH agonist, freeze-all, luteal rescue
2. Youssef MA, Van Wely M, Hassan MA, et al. Can dopamine agonists reduce the incidence and severity of OHSS in IVF/ICSI treatment cycles? A systematic review and meta-analysis. Hum Reprod Update 2010; 16(5):459-466.
3. The Practice Committee of American Society for Reproductive Medicine. Ovarian hypersimulation syndrome. Fertil Steril 2008; 90(5):188-193.
4. Neulen J, Yan Z, Raczek S, et al. Human chorionic gonadotropin-dependent expression of vascular endothelial growth factor/vascular permeability factor in human granulosa cells: importance in ovarian hyperstimulation syndrome. J Clin Endocrinol Metab 1995; 80(6):1967-71.
5. Pellicer A, Albert C, Mercader A, Bonilla-Musoles F, Remohi J, Simon C. The pathogenesis of ovarian hyperstimulation syndrome: in vivo studies investigating the role of interleukin-1beta, interleukin-6, and vascular endothelial growth factor. Fertil Steril 1999; 71(3):482-9.
6. Golan A, Ron-el R, Herman A, Soffer Y, Wienraub Z, Caspi E. Ovarian hyperstimulation syndrome: an update review. Obstet Gynecol Surv 1989; 44(6):430–440.
7. Papanikolaou EG, Pozzobon C, Kolibianakis EM, et al. Incidence and prediction of ovarian hyperstimulation syndrome in woman undergoing gonadotropin-releasing hormone antagonist in vitro fertilization cycles. Fertil Steril 2006; 85(1):112-120.
8. Ocal P, Sahmay S, Cetin M, Irez T, Guralp O, Cepni I. Serum anti-Mullerian hormone and antral follicle count as predictive markers of OHSS in ART cycles. J Assist Reprod Genet 2011; 28(12):1197-1203.
9. Lee TH, Liu CH, Huang CC, et al. Serum anti-Mullerian hormone and estradiol levels as predictors of ovarian hyperstimulation syndrome in assisted reproduction technology cycles. Hum Reprod 2008; 23(1):160-167.
10. Steward RG, Lan L, Shah AA, et al. Oocyte number as a predictor for ovarian hyperstimulation syndrome and live birth: an analysis of 256,381 in vitro fertilization cycles. Fertil Steril 2014; 101(4):967-973.
11. Engmann L, DiLuigi A, Schmidt D, Nulsen J, Maier D, Benadiva C. The use of gonadotropin-releasing hormone (GnRH) agonist to induce oocyte maturation after cotreatment with GnRH antagonist in high-risk patients undergoing in vitro fertilization prevents the risk of ovarian hyperstimulation syndrome: a prospective randomized controlled study. Fertil Steril 2008; 89(1):84-91.
12. Radesic B, Tremellen K. Oocyte maturation employing a GnRH agonist in combination with low-dose hCG luteal rescue minimizes the severity of ovarian hyperstimulation syndrome while maintaining excellent pregnancy rates. Hum Reprod 2011; 26(12):3437-3442.
13. Seyhan A, Ata B, Polat M, Son WY, Yarali H, Dahan MH. Severe early ovarian hyperstimulation syndrome following GnRH agonist trigger with the addition of 1500 IU hCG. Hum Reprod 2013; 28(9):2522-2528.
14. Humaidan P, Ejdrup Bredkjaer H, Westergaard LG, Yding Andersen C. 1,500 IU human chorionic gonadotropin administered at oocyte retrieval rescues the luteal phase when gonadotropin-releasing hormone agonist is used for ovulation induction: a prospective, randomized, controlled study. Fertil Steril 2010; 93(3):847-854.
15. Crisan O, Speranta I. Patients rights in pharmacy legislation. Farmacia 2014; 62(3):444-450.
16. van Wely M, Twisk M, Mol BW, van der Veen F. Is twin pregnancy necessarily an adverse outcome of assisted reproductive technologies? Hum Reprod 2006; 21(11):2736–2738.
17. Belaisch-Allart J. Is twin pregnancy necessarily an adverse outcome of assisted reproductive technologies? Hum Reprod 2007; 22:1495.
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