Odds of ovarian hyperstimulation syndrome (OHSS) - time for reassessment.
BACKGROUND
Ovarian hyperstimulation syndrome (OHSS) is a potentially life-threatening complication of Assisted Reproductive Technology (ART) treatment. The objective of this study was to assess the odds of OHSS hospital admission in relation to oestradiol levels on day of hCG administration and number of oocytes collected.


METHODS
We performed a 24 months retrospective analysis of a cohort of patients receiving ART treatment in a University teaching hospital including all patients requiring admission due to OHSS. Main outcome measures were oestradiol levels, number of oocytes collected and incidence of admission with OHSS.


RESULTS
OHSS requiring admission to hospital occurred in 1.8% of cases. While no patients with an oestradiol level at hCG </=15,000 pmol/L developed OHSS, those with oestradiol levels >/=15,000 pmol/L had different risks of admission according to the number of oocytes collected: those with >30 oocytes were 6.7 times more likely to be admitted that those with <20 oocytes.


CONCLUSIONS
This study identifies an oestradiol level (>/=15,000 pmol/L) and number of oocytes (>/=20) above which the odds of being admitted with OHSS increases significantly. Although OHSS cannot always be prevented, these measurable parameters should be used to allow appropriate counselling and subsequent safe management of ART patients.
Mocanu
Edgar
E
Human Assisted Reproduction Ireland (HARI) Unit, Dublin, Ireland. emocanu@rcsi.ie
Redmond
Marie Louise
ML
Hennelly
Bernadette
B
Collins
Claire
C
Harrison
Robert
R
D002452:Cell Count; D006063:Chorionic Gonadotropin / Q000008:administration & dosage; D004624:Embryo Transfer; D004958:Estradiol / Q000097:blood; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D009865:Oocytes / Q000166:cytology; D016471:Ovarian Hyperstimulation Syndrome / Q000097:blood / Q000453:epidemiology*; D010062:Ovulation Induction / Q000009:adverse effects; D011247:Pregnancy; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors