OBJECTIVE: To reappraise the currently available evidence, providing the answer to the following question: does intravenous albumin administration reduce the risk of severe ovarian hyperstimulation syndrome (OHSS) occurrence following ovarian stimulation with gonadotrophins and GnRH analogues for IVF in high-risk patients? DESIGN: Systematic review and metaanalysis. SETTING: University-based hospital. INTERVENTION(S): Intravenous albumin administration in high-risk patients for prevention of severe OHSS occurrence. MAIN OUTCOME MEASURE(S): Severe OHSS occurrence. RESULT(S): Eight eligible randomized controlled trials were identified (n=1,199 patients) that offered data for statistical pooling. No statistically significant difference in the occurrence of severe OHSS in patients who received intravenous albumin (n=595) and those who did not (n=604; odds ratio [OR], 0.80; 95% confidence interval [CI], 0.52-1.22) was detected. Moreover, no statistically significant differences were present regarding the probability of pregnancy (OR, 0.83; 95% CI, 0.64-1.07) and first trimester pregnancy loss (OR, 1.44; 95% CI, 0.73-2.85) between patients who received intravenous albumin and those who did not. CONCLUSION(S): Based on the currently best available evidence, intravenous albumin administration in high-risk patients does not appear to reduce the occurrence of severe OHSS. This finding should be considered when implementing strategies for severe OHSS prevention.
OBJECTIVE: To reappraise the currently available evidence, providing the answer to the following question: does intravenous albumin administration reduce the risk of severe ovarian hyperstimulation syndrome (OHSS) occurrence following ovarian stimulation with gonadotrophins and GnRH analogues for IVF in high-risk patients? DESIGN: Systematic review and metaanalysis. SETTING: University-based hospital. INTERVENTION(S): Intravenous albumin administration in high-risk patients for prevention of severe OHSS occurrence. MAIN OUTCOME MEASURE(S): Severe OHSS occurrence. RESULT(S): Eight eligible randomized controlled trials were identified (n=1,199 patients) that offered data for statistical pooling. No statistically significant difference in the occurrence of severe OHSS in patients who received intravenous albumin (n=595) and those who did not (n=604; odds ratio [OR], 0.80; 95% confidence interval [CI], 0.52-1.22) was detected. Moreover, no statistically significant differences were present regarding the probability of pregnancy (OR, 0.83; 95% CI, 0.64-1.07) and first trimester pregnancy loss (OR, 1.44; 95% CI, 0.73-2.85) between patients who received intravenous albumin and those who did not. CONCLUSION(S): Based on the currently best available evidence, intravenous albumin administration in high-risk patients does not appear to reduce the occurrence of severe OHSS. This finding should be considered when implementing strategies for severe OHSS prevention.