title: Venous thrombosis during assisted reproduction: novel risk reduction strategies.
abstract: Ovarian hyperstimulation syndrome (OHSS) affects 5% of IVF cycles and incurs a 100-fold increase in risk of venous thrombosis over natural conceptions. Identification of women at risk of OHSS can be achieved using antral follicle count (AFC) and anti-Müllerian hormone (AMH). For those women with a high AFC or AMH combining a GnRH antagonist with a conventional hCG trigger will reduce the risk of OHSS and still allow a fresh transfer to occur. Complete abolition of OHSS is however now a reality by avoiding exposure to exogenous hCG. This can be achieved by segmentation of the IVF cycle using a GnRH agonist for final oocyte maturation and then freezing all oocytes or embryos with subsequent replacement of a single embryo in the context of a frozen embryo transfer. This novel approach will ensure a VTE risk equivalent to natural conception and can be combined with conventional thromboprophylaxis strategies.
authors: School of Medicine, University of Glasgow, Glasgow, UK. scott.nelson@glasgow.ac.uk
authors: Scott M
authors: SM
authors: Nelson
mesh_terms: D054304:Anti-Mullerian Hormone / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D004624:Embryo Transfer; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D007246:Infertility / Q000628:therapy; D009865:Oocytes / Q000166:cytology; D006080:Ovarian Follicle / Q000473:pathology; D016471:Ovarian Hyperstimulation Syndrome / Q000150:complications* / Q000517:prevention & control; D010062:Ovulation Induction; D027724:Reproductive Techniques, Assisted; D012307:Risk Factors; D020246:Venous Thrombosis / Q000150:complications* / Q000517:prevention & control*
chemical_list: D015415:Biomarkers; D007987:Gonadotropin-Releasing Hormone; D054304:Anti-Mullerian Hormone