Journal of Reproduction & Infertility

Journal of Reproduction & Infertility

The role of intravenous albumin in the prevention of severe ovarian hyperstimulation syndrome in ART cycles

Authors
Ensieh Sh.Tehrani 1
Sousan Ziaei 2
1 Department of Gynecology and Obstetrics ,Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Royan Research Center, Endocrinology & Infertility Department, Tehran, Iran
2 Department of Obstet . and Gynecol . of Tehran Medical Sciences University .Emam khomayni Hospital، Valiaser Hospital, Tehran, Iran
Abstract
The objective of this study was to evaluate the effect of ablumin on inhibition of severe ovarian hyperstimulation syndrome (OHSS) in women at high risk. A prospective, interventive and randomized study was planned and performed at the IVF department of the Royan Research Center. Ninety high risk patients from moderate to serere OHSS who were undergoing IVF ICSI cycles, were divided in two groups. 57 patients in the study group and 33 in the control group. At the time of oocyte recovery,50gr human albumin in 500 ml of normal saline (N.S) was injected to the study group. The control group only received 500 ml N.S. All patients in study and control groups were matched for age, number of oocytes, level of Estradiol at the time of hCG injection, duration of Follicular phase, amount of hMG used and the number of the transferred embryos. Of the 57 patients in the study group, one had OHSS, while in the control gourp, 4 OHSS patient was found in 33 patients (1/8% versus2% , p<0.05). We conclude that prophylactic infusion of human serum albumin can reduce or mitigate severe OHSS in patients at high risk.
Keywords
Albumin
IVF
OHSS
Schenker JG, Weinstein D. Ovarian hyperstimulation syndrome: a current survey.Fertil Steril. 1978, 30:255-68.
Navot D,Bergh PA, Laufer N. Ovarian hyperstimulation syndrome in novel reproductive technologies: prevention and treatment. Feril Steril. 1992, 58:249-261.
Mills MS, Eddowes HA, Fox R, Subclavian vein thrombosis: a late complication of ovarian hyperstimulation syndrome. Hum Reprod. 1992, 7:370-371.
Hignett M, Spence JEH, Claman P. Internal jugular vein thrombosis: a late complication of ovarian hyperstimulation syndrome despite mini-dose heparin prophylaxis.Hum Reprod. 1995, 10:3121-3123.
Zosmer A, Katz Z, Lancet M. Adult respiratory distress syndrome complicating ovarian hyperstiumlation syndrome.Fertil Steril. 1987, 47:527-526.
Delbaere A, Bergmann PJM, Gervy-Decoster C, et. al. Prorenin and active renin concentrations in plasma and ascites during severe ovarian hyperstimulation syndrome.Hum Reprod. 1997, 12:236-240.
Schenker JG, Polishuk WZ. Role of prostaglandins in ovarian hyperstimulation syndrome. Obstet Gynecol. 1976, 31:742-745.
Dinarello CA, Gelfand JA, Wolff SM, et al. Anticytokine strategies in the treatment of the systemic inflammatory response syndrome. AM J Med Assoc. 1993, 269:1829-35.
McClure N, Healy DL, Rogers PAW, et al. Vascular endothelial growth factor as capillary premeability agent in ovarian hyperstimulation syndrome. Lancet. 1994, 344:235-6.
Abramov Y, Barak V, Nisman B, et al. Vascular endothelial growth factor plasma levels correlate to the clinical picture in severe ovarian hyperstimulation syndrome. Fertil Steril. 1997, 67:261-5.
Friddlander MA, Loret de Mola JR, Goldfarb JM, et. al. Elevated levels of interleukin –6 in ascites and serum from women with ovarian hyperstimulation. Fertil Steril.1993,60:826-33.
Revel A, Barak V, Lavy Y, et al. Characterization of intraperitioneal cytokines and nitrites in women with severe ovarian hyperstimulation syndrome. Fertil Steril. 1996, 66:66-71.
Krasnow JS, Berga SL, Guzick DS, et al. Vascular permeability factor and vascular endothelial grwoth factor in ovarian hyperstimulation syndrome: a preliminary report.Fertil Steril. 1996, 65:552-5.
Loret de Mola JR, Baumgardner GP, Goldfarb JM, et al. Elevated interleukin-6 levels in the ovarian hyperstimulation syndrom:ovarian immunohistochemicallocalization of interleukin –6 signal. Obstet Gynecol. 1996, 87: 58-7.
Asch RH, Balmaceda JP. Severe ovarian hyperstimulation sydndrome in assisted reproductive technology: definition of high risk groups. Hum Reprod. 1991, 6:1395-1399.
Lewit N, Kol S, Manor D. Comparison of gonadotrophin releasing hormone analogues and human chorionic gonadotrophin for the induction of ovulation and prevention of ovarian hyperstimulation syndrome: a case-control study. Hum Reprod. 1996, 11: 1399-1402.
Asch RH, Ivery G, Godsman M, et al. The use of intravenous albumin in patients at high risk for severe ovarian hyerstimulation syndrome. Hum Reprod. 1993:8:1015-1020.
Shoham Z, Weissman A, et al. Intravenous albumin for the prevention of severe ovarian hyperstimulation syndrome in an in vitro fertilization program: a prospective, randomized, placebo-controlled study. Fertil Steril. 1994, 62:137-142.
Shalev E, Giladi Y, Matilsky M, et al. Decreased incidence of severe ovarian hyperstimulation syndrome in high risk in vitro fertilization patients receiving intravenous albumin: a prospective study. Hum Reprod. 1995,10:1373-1376.
Morris RS, Paulson RJ. Letter to the Editor: Does intravenous albumin prevent ovarian hyperstimulation sydnrome? Hum Reprod. 1994, 9:753.
Lewit N, Kol S, Ronen N, et al. Does intravenous administration of human albumin.prevent severe ovarian hyperstimulation syndrome? Fertil Steril. 1996, 66:654-656
Mukherjee T, Copperman AB, SandlerB, et al. Severe ovarian hyperstimulation despite prophylactic albumin administration at the time of oocyte retrieval for in vitro fertilization and embryo transfer. Fertil Steril. 1995, 64:641-643.
Orvieto R, Dekel A, Dicker D, et al. Asevere Case of ovarian hyperstimulation syndrome despite the prophylactic administration of intravenous albumin.Fertil Steril. 1995, 64:860-862.
Ng E, Leader A, Claman P, et al. Intravenous albumin does not prevent the development of severe ovarian hyperstiumlation syndrome in an in vitro fertilization programme. Hum Reprod. 1995, 10:807-810.
Journal of Reproduction & Infertility
Volume 1, Issue 3
Summer 2000
Pages 12-17