| Complications of ovarian stimulation. | |
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MedLine Citation:
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PMID: 10627768 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We review three complications of ovarian stimulation, namely ovarian hyperstimulation syndrome, thromboembolic disease in relation to fertility treatment and multiple pregnancy. Current views on the ovarian hyperstimulation syndrome emphasize its association with the presence of polycystic ovaries. We review here the pathophysiological background of this association and focus on the central role of vascular endothelial growth factor (VEGF). Overexpression of VEGF in the polycystic ovary is thought to contribute to its characteristic multifollicular response to gonadotrophic stimulation. Release of large amounts of VEGF into the circulation is thought to account for the development of the clinical syndrome of ovarian hyperstimulation. The implications of this understanding are explored and the clinical features of the condition and its management are described. Thromboembolic disease is increasingly recognized as a serious if rare complication of infertility treatment. The subject is reviewed here with special reference to two recently published and important papers. The most concerning complication of infertility treatment is multiple pregnancy. Few doctors seem to be aware of the dire statistics: every index of obstetric outcome is adversely affected. The survival, health and family circumstances of children born as the result of multifetal gestation are all impaired. Infertility patients need a clear understanding of the risks involved so that they can appreciate the need for intensive monitoring of ovarian stimulation. In our opinion a knowledge of the rate of multiple pregnancy is quite as important as knowing the clinic's 'success' rate. |
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Authors:
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H S Jacobs; R Agrawal |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
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Title: Baillière's clinical obstetrics and gynaecology Volume: 12 ISSN: 0950-3552 ISO Abbreviation: Baillieres Clin Obstet Gynaecol Publication Date: 1998 Dec |
Date Detail:
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Created Date: 2000-02-01 Completed Date: 2000-02-01 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8710782 Medline TA: Baillieres Clin Obstet Gynaecol Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 565-79 Citation Subset: IM |
Affiliation:
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Department of Endocrinology, UCL School of Medicine, Middlesex Hospital, London, UK. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Female Gonadotropins / adverse effects* Humans Infant Infant Mortality Ovarian Hyperstimulation Syndrome / etiology Ovary / drug effects* Ovulation Induction / adverse effects* Polycystic Ovary Syndrome / drug therapy* Pregnancy Pregnancy, Multiple Stimulation, Chemical Thromboembolism / etiology |
| Chemical | |
Reg. No./Substance:
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0/Gonadotropins |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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