title: Can steroidal ovarian suppression during the luteal phase after oocyte retrieval reduce the risk of severe OHSS?
abstract: BACKGROUND
  Ovarian stimulation in IVF cycle results in luteal supraphysiological steroid concentrations especially for high response patients. The aim of this study was to evaluate the efficacy of ovarian steroid hormone suppression in luteal phase after oocyte retrieval for preventing severe ovarian hyperstimulation syndrome (OHSS) in high-risk patients with embryo cryopreservation.
  
  
  METHODS
  281 patients with high risk of OHSS were enrolled in this study among 4735 infertile women undergoing their first IVF treatment. The subjects were allocated into treatment and control group. The treatment group (n = 161) received letrozole (n = 43), mifepristone (n = 51), cetrotide (n = 39) and three-drug combinations (n = 28) during the luteal phase after oocyte retrieval, respectively. The control group (n = 120) received no medicine. Fertilization rate, good embryo rate, serum steroid concentration, clinical outcome, and incidence of severe OHSS were compared between the two groups.
  
  
  RESULTS
  On days 2, 5 and 8 after oocyte retrieval, serum estradiol levels in the letrozole and three-drug combination therapy group were significantly lower than in the other three groups at the same time (P < 0.001, respectively). There were no significantly difference of serum luteinizing hormone concentration on days 2, 5 and 8 and progesterone concentration on day 8 after oocyte retrieval among the five groups (P > 0.05, respectively). Compared with the control group, the incidence of severe OHSS, the paracentesis rate, the duration of hospitalization and the days of luteal phase in each subgroup of treatment groups was not significantly decreased (P > 0.05, respectively).
  
  
  CONCLUSIONS
  Our findings indicate that steroidal ovarian suppression in luteal phase after oocyte retrieval seems to be unable to prevent severe OHSS in high-risk patients with embryo cryopreservation.
authors.affiliation: Reproductive Medical center, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China. wangyaqin1039@163.com.
authors.forename: Ya-Qin
authors.initials: YQ
authors.lastname: Wang
authors.affiliation: Reproductive Medical center, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China. 50375042@qq.com.
authors.forename: Jin
authors.initials: J
authors.lastname: Luo
authors.affiliation: Reproductive Medical center, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China. wmxu609@msn.com.
authors.forename: Wang-Min
authors.initials: WM
authors.lastname: Xu
authors.affiliation: Reproductive Medical center, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China. qingzhenxie@hotmail.com.
authors.forename: Qin-Zhen
authors.initials: QZ
authors.lastname: Xie
authors.affiliation: Reproductive Medical center, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China. 523526931@qq.com.
authors.forename: Wen-Jie
authors.initials: WJ
authors.lastname: Yan
authors.affiliation: Reproductive Medical center, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China. 402865302@qq.com.
authors.forename: Geng-Xiang
authors.initials: GX
authors.lastname: Wu
authors.affiliation: Reproductive Medical center, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China. dryangqing@163.com.
authors.forename: Jin
authors.initials: J
authors.lastname: Yang
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D006063:Chorionic Gonadotropin / Q000008:administration & dosage; D015536:Down-Regulation; D004359:Drug Therapy, Combination; D004958:Estradiol / Q000378:metabolism; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D012739:Gonadal Steroid Hormones / Q000037:antagonists & inhibitors*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006062:Gonadotropins / Q000627:therapeutic use; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D007273:Injections, Intramuscular; D008183:Luteal Phase / Q000502:physiology*; D007986:Luteinizing Hormone / Q000008:administration & dosage; D054315:Oocyte Retrieval / Q000379:methods*; D016471:Ovarian Hyperstimulation Syndrome / Q000517:prevention & control*; D016896:Treatment Outcome; D017329:Triptorelin Pamoate / Q000008:administration & dosage
chemical_list: D006063:Chorionic Gonadotropin; D012739:Gonadal Steroid Hormones; D006062:Gonadotropins; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D007986:Luteinizing Hormone