Ya-Qin Wang1, Jin Luo2, Wang-Min Xu3, Qin-Zhen Xie4, Wen-Jie Yan5, Geng-Xiang Wu6, Jin Yang7. 1. Reproductive Medical center, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China. wangyaqin1039@163.com. 2. Reproductive Medical center, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China. 50375042@qq.com. 3. Reproductive Medical center, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China. wmxu609@msn.com. 4. Reproductive Medical center, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China. qingzhenxie@hotmail.com. 5. Reproductive Medical center, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China. 523526931@qq.com. 6. Reproductive Medical center, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China. 402865302@qq.com. 7. Reproductive Medical center, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China. dryangqing@163.com.
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.
RCT Entities:
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: Eric P Winer; Clifford Hudis; Harold J Burstein; Rowan T Chlebowski; James N Ingle; Stephen B Edge; Eleftherios P Mamounas; Julie Gralow; Lori J Goldstein; Kathleen I Pritchard; Susan Braun; Melody A Cobleigh; Amy S Langer; Judy Perotti; Trevor J Powles; Timothy J Whelan; George P Browman Journal: J Clin Oncol Date: 2002-08-01 Impact factor: 44.544
Authors: T G Lainas; I A Sfontouris; I Z Zorzovilis; G K Petsas; G T Lainas; E M Kolibianakis Journal: Reprod Biomed Online Date: 2007-10 Impact factor: 3.828