Low-dose HCG is useful in preventing OHSS in high-risk women without adversely affecting the outcome of IVF cycles.
Severe ovarian hyperstimulation syndrome (OHSS) is a rare but potentially fatal condition associated with conventional IVF treatment. It is found predominantly in women with polycystic ovaries who have an exaggerated response to exogenous FSH, leading to a large number of follicles and an overproduction of vascular endothelial growth factor with resultant excessive increases in vascular permeability. There is evidence to suggest that OHSS is also linked to the use of human chorionic gonadotrophin (HCG) to induce ovulation. Therefore, while HCG is essential for corpus luteum function, high amounts of HCG can lead to OHSS in high responders. In a pilot study, infertile patients at high risk of developing OHSS were given half the current minimum dose of HCG (i.e. 2500 IU). No woman developed moderate or severe OHSS; 13 women (61.9%) conceived and there were three twin pregnancies. In women at high risk of OHSS, a low dose of HCG appears to prevent the development of OHSS without compromising success rates.
Nargund
Geeta
G
St George's Hospital and Centre for Reproduction and Advanced Technology (Create Health Clinic) London. greetanargund@googlemail.com
Hutchison
Lee
L
Scaramuzzi
Rex
R
Campbell
Stuart
S
D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage* / Q000009:adverse effects; D004958:Estradiol / Q000097:blood; D005260:Female; D006801:Humans; D016471:Ovarian Hyperstimulation Syndrome / Q000517:prevention & control*; D010053:Ovary / Q000000981:diagnostic imaging; D010062:Ovulation Induction / Q000009:adverse effects; D010865:Pilot Projects; D011247:Pregnancy; D018873:Pregnancy Rate; D012306:Risk; D014463:Ultrasonography
D006063:Chorionic Gonadotropin; D004958:Estradiol