Intravenous albumin for the prevention of severe ovarian hyperstimulation syndrome in an in vitro fertilization program: a prospective, randomized, placebo-controlled study.
OBJECTIVE
To evaluate the efficacy of i.v. administration of human albumin solution for the prevention of severe ovarian hyperstimulation syndrome (OHSS).


METHODS
A prospective, randomized, placebo-controlled study comparing the effects of i.v. administration of human albumin solution versus sodium chloride 0.9% solution at the time of oocyte retrieval with patients undergoing IVF-ET who are at high risk for the development of severe OHSS.


METHODS
Specialized assisted reproduction unit.


METHODS
Thirty-one patients undergoing IVF-ET who had serum E2 levels of 1,906 pg/mL (> 7,000 pmol/L) and multiple follicular development on the day of hCG administration.


METHODS
After hCG administration, patients were randomized to receive i.v., either 50 g of human albumin diluted in 500 mL of sodium chloride 0.9% or 500 mL of sodium chloride 0.9% at the time of oocyte retrieval.


METHODS
Ovarian size as measured by pelvic ultrasonography, development of ascites, serum E2 concentrations during the luteal phase, and results of the IVF-ET cycles.


RESULTS
Although no patient who had received human albumin solution developed severe OHSS, there were four such cases in the control group. All four were hospitalized with marked ascites and ovarian enlargement. There were no significant differences between the two groups comparing serum E2 levels on the day of hCG administration and during the luteal phase, the number of oocytes retrieved, fertilization, and pregnancy rates.


CONCLUSIONS
Our preliminary results suggest that the administration of human albumin solution may help to prevent the development of severe OHSS in high-risk patients. Further research is needed to assess the potential of this novel approach.
Shoham
Z
Z
Department of Obstetrics and Gynecology, Kaplan Hospital, Rehovot, Israel.
Weissman
A
A
Barash
A
A
Borenstein
R
R
Schachter
M
M
Insler
V
V
D000328:Adult; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007275:Injections, Intravenous; D016471:Ovarian Hyperstimulation Syndrome / Q000517:prevention & control*; D010919:Placebos; D011446:Prospective Studies; D012709:Serum Albumin / Q000627:therapeutic use*
D006063:Chorionic Gonadotropin; D010919:Placebos; D012709:Serum Albumin