Severe ovarian hyperstimulation syndrome: Can we eliminate it through a multipronged approach?
Journal Title: Medical Journal Armed Forces - Year 2018, Vol 74, Issue 1
Abstract
Background: Prevention of severe Ovarian Hyperstimulation Syndrome (OHSS), a potentially fatal complication of controlled ovarian hyperstimulation has been the aim of all fertility experts. Various pharmacologic and non-pharmacologic interventions have been instituted but the results have been conflicting. These preventive strategies were administered in isolation or as a combination of few aiming to eliminate this iatrogenic sequel. This study aimed to eliminate severe OHSS by multipronged approach incorporating almost all preventive modalities available in patients at high risk for this dreadful complication. Methods: It was a prospective observational study wherein 112 high risk patients planned for IVF were studied. The multipronged approach was in the form administering calcium gluconate infusion, cabergoline, albumin infusion, GnRH antagonist in luteal phase in addition to elective cryopreservation of embryos. The primary outcome measure was incidence of severe OHSS in the study group and the rate of hospitalisation. The secondary outcome measure was the number of days required for complete recovery and resolution of signs and symptoms. Results: Out of the 112 high risk patients only one patient (1/112; 0.9%) developed severe OHSS with an overall incidence of 0.095% of severe OHSS in all the cycles. There was no biochemical or haematological derangement in any of the high risk patients. Conclusion: Although this is the first study evaluating the multipronged approach in preventing the dreaded complication of severe OHSS, it does add to the knowledge that targeting the various pathophysiological pathways at different time frames will bring about prevention of OHSS but further randomised studies may reveal superiority of one intervention over the other.
Authors and Affiliations
Nikita Naredi
Keywords
Related Articles
- EP ID EP640082
- DOI 10.1016/j.mjafi.2017.04.006
- Views 65
- Downloads 0
Publish and flourish: Take the road less travelled!
Scientific research and publications are essential for advancement of medical knowledge. The perceived need for 'publications' in medical journals, has increased substantially in view of the recently mandated requirement...
MR Geyser Sign in chronic rotator cuff tears
Acromio-clavicular (AC) joint cysts are rare presentation of chronic shoulder pathology. These cysts may be observed secondary to either degenerative changes in the AC joint with an intact rotator cuff (type 1 cyst) or f...
Forward surgical care: Emerging issues and challenges.
War strategies have been evolving with time and battlefield casualty care services have been trying to keep pace with the changing demands. Technological advances in the field of trauma care have revolutionised the way i...
The psychological morbidity in the long term after war related bilateral lower limb amputation
Background: To determine the psychological morbidity in the long term after war related bilateral lower limb amputation. Methods: Mental health status was determined by the Symptom Checklist-90-R (SCL-90-R) and a structu...
Is it possible to control publication of predatory journals?
In the recent years, there is mushrooming of many so called National and International journals, which are being published not only from India but also from affluent countries. These journals are not indexed in standard...