Abstract
The aim of the present pilot study was to assess the feasibility and efficacy of Cetrotide administration in the early luteal phase in patients at high risk of ovarian hyperstimulation syndrome (OHSS), undergoing embryo cryopreservation following superovulation. A total of 135 patients at high risk of OHSS and undergoing embryo cryopreservation were divided into two groups. In the treatment group (n=39), the patients received daily subcutaneous injections of 0.25 mg Cetrotide between days 1 and 5 following ooctye retrieval, and volume expansion and symptomatic treatment were also provided. In the control group (n=96), the patients received routine treatments, including volume expansion therapy. The serum steroid hormone concentrations of the patients were measured on days 2, 5 and 8 following ooctye retrieval, while the incidence of moderate or severe OHSS, self-evaluated clinical symptoms and various clinical indicators were recorded. The serum estradiol (E2), luteinizing hormone and progesterone levels in the treatment group on days 2, 5 and 8 following oocyte retrieval were not found to differ significantly when compared with the patients in the control group (P>0.05). The incidence of severe OHSS did not differ significantly between the two groups (P>0.05). The average length of hospital stay and length of luteal phase were not found to be significantly different between the treatment and control groups (P>0.05). In conclusion, Cetrotide injections in the early luteal phase did not alter the serum steroid levels of patients at high risk of OHSS undergoing embryo cryopreservation, and were unable to reduce the incidence of severe early OHSS. However, further randomized studies are required to evaluate the effectiveness of Cetrotide in the prevention of OHSS.
Highlights
Ovarian hyperstimulation syndrome (OHSS) is a serious iatrogenic complication that may occur following ovarian stimulation/superovulation
Delaying embryo transfer with embryo cryopreservation reduces the occurrence of pregnancy‐associated late OHSS; there are still no precise methods to completely eliminate the incidence of human chorionic gonadotrophin (HCG)-induced severe early‐onset OHSS
Body mass index (BMI), number of cases of polycystic ovary syndrome (PCOS), duration of infertility, baseline follicle‐stimulating hormone levels, baseline E2 levels, duration of Gn stimulation and Gn dose were compared between the treatment and control groups
Summary
Ovarian hyperstimulation syndrome (OHSS) is a serious iatrogenic complication that may occur following ovarian stimulation/superovulation. Delaying embryo transfer with embryo cryopreservation reduces the occurrence of pregnancy‐associated late OHSS; there are still no precise methods to completely eliminate the incidence of human chorionic gonadotrophin (HCG)-induced severe early‐onset OHSS. The use of GnRH‐ant has been associated with a significantly lower incidence of OHSS and E2 concentrations as compared with GnRH agonist (GnRH‐a) [4]. It has previously been reported that luteal‐phase GnRH‐ant administration prevents patient hospitalization for patients with established severe early‐onset OHSS and results in the quick regression of the syndrome on an outpatient basis [5,6]. Whether luteal‐phase GnRH‐ant administration can block the pathogenesis of OHSS and reduce the risk of severe OHSS has yet to be verified
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