Document Detail


Optimal follicle and oocyte numbers for cryopreservation of all embryos in IVF cycles at risk of OHSS.
MedLine Citation:
PMID:  18765000     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Ovarian hyperstimulation syndrome (OHSS) is a rare but potentially fatal complication of IVF treatment. The risk of OHSS increases with increasing numbers of follicles aspirated and oocytes retrieved, but there is little evidence to support whether threshold values of either can be used to correctly predict OHSS. Since the most severe forms of OHSS are usually associated with pregnancy, cryopreservation of all embryos may prevent this. The authors attempted to find thresholds of follicle and oocyte numbers that would optimally predict OHSS, through a retrospective analysis of 2253 consecutive cycles of IVF/intracytoplasmic sperm injection treatment reaching oocyte retrieval, between 1 January 2003 and 31 March 2006. Receiver operator characteristic (ROC) curves were calculated for both parameters, to determine threshold values that might predict OHSS in women with > or =20 oocytes. For the prediction of early onset OHSS, ROC curves showed that an optimal balance between sensitivity and specificity was achieved using thresholds of 24 oocytes (79%, 60%) and 29 follicles (82%, 65%) respectively. Using these thresholds, cryopreservation of all embryos may be offered as an alternative to cancellation of a treatment cycle due to excessive ovarian response, thus minimizing the number of unnecessary interventions while still correctly predicting most cases of early onset OHSS.
Authors:
Gideon R Verwoerd; Thomas Mathews; Peter R Brinsden
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Reproductive biomedicine online     Volume:  17     ISSN:  1472-6491     ISO Abbreviation:  Reprod. Biomed. Online     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-09-03     Completed Date:  2008-10-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101122473     Medline TA:  Reprod Biomed Online     Country:  England    
Other Details:
Languages:  eng     Pagination:  312-7     Citation Subset:  IM    
Affiliation:
Assisted Conception Unit, Bourn Hall Clinic, Bourn, Cambridge, UK. gideon.verwoerd@lcg-bourn.co.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Cryopreservation*
Embryo, Mammalian*
Female
Fertilization in Vitro / methods
Humans
Oocytes / cytology*
Ovarian Follicle / cytology*
Ovarian Hyperstimulation Syndrome / etiology*
Pregnancy
ROC Curve
Retrospective Studies
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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