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 89
- Downloads 0
Man and Microbe: Fraternizing with the frenemy
Man's fate has been intricately intertwined with that of microbes since the beginning of his existence. Microbes are possibly our best friends. We share an exceptional symbiotic relationship with them, with each one of u...
Prospective applications of induced pluripotent stem cells in military medicine
Soldiers involved in combat operations worldwide may be subjected to a wide array of tissue-specific injuries of varying degrees, thereby undergoing complicated medical treatments and prolonged rehabilitations. In many c...
Nasal myiasis by Chrysomya bezziana
Myiasis is a pathogenic condition found in live humans and animals caused by various species of dipteran larvae. Chrysomya bezziana, also known as old world screwworm, is an obligate parasite in mammals and is known to i...
Meningitis caused by Lactococcus garvieae
Lactococcus garvieae, originally a fish pathogen, has very rarely been isolated from human infections, mainly infective endocartditis.1–3 Most of the patients in the reported cases of human infections had a positive hist...
Changing paradigm in the scientific publication process: Are we encouraging Science or Pseudoscience? Urgent need for introspection and self regulation
Scientific research and its subsequent publication in a peer reviewed journal (preferably) are essential components of professional development in the field of medicine. Scientists have endeavored over the centuries to i...