title: 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.affiliation: Human Reproductive Biology Unit, Soliman Fakeeh Hospital, Jeddah, Saudi Arabia.
authors.forename: D A
authors.initials: DA
authors.lastname: Imoedemhe
authors.forename: R C
authors.initials: RC
authors.lastname: Chan
authors.forename: A B
authors.initials: AB
authors.lastname: Sigue
authors.forename: E L
authors.initials: EL
authors.lastname: Pacpaco
authors.forename: A B
authors.initials: AB
authors.lastname: Olazo
mesh_terms: D000328:Adult; D004624:Embryo Transfer; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000378:metabolism; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D007986:Luteinizing Hormone / Q000378:metabolism; D009865:Oocytes / Q000166:cytology; D016471:Ovarian Hyperstimulation Syndrome / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D010062:Ovulation Induction / Q000009:adverse effects* / Q000379:methods; D011374:Progesterone / Q000097:blood; D012307:Risk Factors
chemical_list: D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone