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Identification of the high-risk patient for ovarian hyperstimulation syndrome.
MedLine Citation:
PMID:  21082503     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
Ovarian hyperstimulation syndrome (OHSS), an iatrogenic complication of ovarian stimulation for assisted reproduction, is a potentially life-threatening condition. Exogenous human chorionic gonadotropin (hCG) administered for final oocyte maturation and endogenous hCG produced by a developing pregnancy are fundamental in the development of the disease. Vascular endothelial growth factor is the key molecule mediating the pathophysiology of the syndrome, and genetic predisposition might play a role. Because the most severe cases are usually the late OHSS cases that occur when a pregnancy is established, several predictive markers have been introduced to identify the high-risk patient profile and consequently develop preventive strategies. This article reviews the most recent evidence evaluating the accuracy of different OHSS prediction parameters. Stratification was attempted according to the phase of the ovarian stimulation that the patients undergo. Anti-Müllerian hormone and the number of follicles seen on ultrasound seem promising discriminating factors, whereas prediction models that include age, antral follicle count, and estrogen levels on the day of ovulation triggering provide variable sensitivity and specificity. Until reliable genetic tests are available, and considering that the occurrence of pregnancy is unpredictable, the use of prognostic factors will be mainly indicative of risk rather than preventive of OHSS.
Authors:
Evangelos G Papanikolaou; Peter Humaidan; Nikolaos P Polyzos; Basil Tarlatzis
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Publication Detail:
Type:  Journal Article     Date:  2010-11-16
Journal Detail:
Title:  Seminars in reproductive medicine     Volume:  28     ISSN:  1526-4564     ISO Abbreviation:  Semin. Reprod. Med.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100909394     Medline TA:  Semin Reprod Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  458-62     Citation Subset:  IM    
Copyright Information:
© Thieme Medical Publishers.
Affiliation:
Assisted Reproduction Unit, 1st OB-GYN Department, Aristotle University of Thessaloniki, Thessaloniki, Greece. papanikolaou@irg.gr
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