title: [Elective cryopreservation of all embryos in women at risk of ovarian hyperstimulation syndrome: prevention and efficiency].
abstract: OBJECTIVE
  To evaluate the benefits, regarding prevention and clinical pregnancy rates, of embryos cryopreservation in patients at high risk of ovarian hyper-stimulation.
  
  
  METHODS
  Retrospective study with 66 patients divided into two groups. Group 1 (n=24), cryopreservation of all the embryos due to high risk of OHSS. Group 2 (n=42), fresh embryo transfer despite of ovarian hyper-response (E2>4000/mL, hCG day). We performed a comparative analysis for group 1 and 2 regarding implantation, pregnancy, live birth and spontaneous abortion rates.
  
  
  RESULTS
  No case of OHSS was observed in group 1 and 40.5 % in group 2. Fresh embryo transfer in group 2 gave the following results: 12.9 % implantation rate, 21.4 % pregnancy rate per transfer and 22.2 % spontaneous abortion. Identical implantation and pregnancy rates after frozen ET cycles were observed in both groups. Whereas live birth rates were significantly better in group 1 (15.4 % vs. 67 %, P=0.04) with a significant lower rate of spontaneous abortion (27 % vs. 11.4 %, P<0,01).
  
  
  CONCLUSIONS
  The negative impact of hyperestrogenic state seems to be limited to endometrial receptivity with no effect on oocyte or embryo quality. In situation of ovarian hyper-response, cryopreservation of all embryos with subsequent transfer of thawed embryos is an efficient strategy to avoid OHSS without decreasing pregnancy and live birth rates.
authors.affiliation: Service de médecine de la reproduction, université Paris XIII, hôpital Jean-Verdier, AP-HP, avenue du 14-Juillet, Bondy, France.
authors.forename: P
authors.initials: P
authors.lastname: Massart
authors.forename: N
authors.initials: N
authors.lastname: Sermondade
authors.forename: C
authors.initials: C
authors.lastname: Dupont
authors.forename: C
authors.initials: C
authors.lastname: Sifer
authors.forename: I
authors.initials: I
authors.lastname: Cedrin-Durnerin
authors.forename: J N
authors.initials: JN
authors.lastname: Hugues
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D015925:Cryopreservation; D010064:Embryo Implantation; D004624:Embryo Transfer; D004622:Embryo, Mammalian; D005260:Female; D006801:Humans; D050498:Live Birth; D016471:Ovarian Hyperstimulation Syndrome / Q000150:complications*; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D012307:Risk Factors