title: Hematocrit as a simple method to predict and manage ovarian hyperstimulation syndrome in assisted reproduction.
abstract: OBJECTIVE
  The aim was to analyze the hematocrit levels in cases of ovarian hyperstimulation syndrome (OHSS), syndrome occurring during in-vitro fertilization (IVF), and study its role as a prognostic indicator.
  
  
  METHODS
  Two years data of 66 women at high risk for developing OHSS was analyzed. Twenty-seven women who developed OHSS were further analyzed based on their hematocrit levels on the day of oocyte pick-up (OPU) and the day of embryo transfer (ET) to see if there was a prognostic trend.
  
  
  RESULTS
  Of the total 225 IVF cases, 66 were deemed high risk for developing OHSS. Twenty-seven of these developed OHSS (40.9%). Of these 27, 21 (77.8%) had a hematocrit >35% on the day of OPU. The mean hematocrit in women developing OHSS on the day of OPU was 37.39% (standard deviation [SD] 2.66) as against 35.97% (2.80) in those not developing OHSS. This difference was statistically significant (P = 0.043). On the day of ET, 23/27 (85.8%) who developed OHSS had a hematocrit of >35%. The mean hematocrit was 39.29% (SD 3.85) in those who developed OHSS as against 34.7% (2.88) in those who did not. This difference (4.85) was statistically significant (P < 0.001).
  
  
  CONCLUSIONS
  Women undergoing IVF were at a higher risk of developing OHSS when their hematocrit on the day of OPU and ET was >35%. Those who required cancellation of ET had a hematocrit of >35% on the day of ET or showed a significant increase of 3% from OPU to ET.
authors.affiliation: Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
authors.forename: Taswin
authors.initials: T
authors.lastname: Kaur
authors.affiliation: Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
authors.forename: Praveena
authors.initials: P
authors.lastname: Pai
authors.affiliation: Department of Obstetrics and Gynaecology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
authors.forename: Pratap
authors.initials: P
authors.lastname: Kumar
keywords: In-vitro fertilization; hematocrit; ovarian hyperstimulation