Abstract
ObjectivesTo evaluate the effect of dyslipidemia on the incidence of moderate and severe Ovarian hyperstimulation syndrome (OHSS) in the duration of assisted reproduction technique (ART).MethodsThe study included 233 moderate and severe OHSS patients who received hospitalization after in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycles to avoid severe complications. They were divided into dyslipidemia group and normal lipid metabolism group to evaluate whether dyslipidemia contributes to the development of severe OHSS. Subgroup analysis was set to avoid deviation including the freeze-all group and fresh embryo transfer (ET) group according to whether the eligible women chose fresh embryo transfer immediately after their IVF or ICSI cycles. The main outcome measures included the incidence of moderate OHSS and severe OHSS, total gonadotropin dose, number of oocytes retrieved, age and body mass index (BMI). In the ET groups, the rate of pregnancy is also included for analysis.ResultsIn the freeze-all group, lipid metabolism was ultimately identified as the factor affecting the morbidity of severe OHSS and the ones with dyslipidemia were more likely to develop to severe OHSS (P < 0.05), while the incidence of severe OHSS among the ET groups had no statistical significance (P > 0.05).ConclusionThe findings of this study suggested that dyslipidemia might contribute to the development of OHSS, especially for those patients who chose the cryopreservation of all embryos. It is essential to consider the risk of OHSS in patients with dyslipidemia although they required cryopreservation of all embryos.
Highlights
In recent decades, about one in seven couples encounter problems with fertility (European in vitro fertilization (IVF)-monitoring programme (EIM) for the European Society of Human Reproduction and Embryology (ESHRE) et al, 2006), and couples increasingly turn to assisted reproductive technology (ART) for help
The Chinese guidelines on prevention and treatment of dyslipidemia have defined a high concentration of total cholesterol (TC) as ≥240 mg/dL or low-density lipoprotein cholesterol (LDL-C) as ≥160 mg/dL, with or without a low concentration of high-density lipoprotein cholesterol (HDL-C) as 40 mg/dL, which were defined as dyslipidemia (Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults, 2016)
It is showed that the incidence of severe ovarian hyperstimulation syndrome (OHSS) in the Embryo Transfer (ET) group was higher than that in the freeze-all group, but the difference between 2 groups had no significance (35.2% vs. 26.1%, P = 0.137)
Summary
About one in seven couples encounter problems with fertility (European IVF-monitoring programme (EIM) for the European Society of Human Reproduction and Embryology (ESHRE) et al, 2006), and couples increasingly turn to assisted reproductive technology (ART) for help. Vascular endothelial growth factor (VEGF) and the cytokine interleukin-6 (IL-6) have been identified as potential mediators in the development of OHSS because of their vasoactive properties, which increase the permeability of capillaries (Motro et al, 1990; Pellicer et al, 1999; Miller et al, 2016). It is still unknown that whether dyslipidemia cause the damage of microvasculature in ovary, the correlation between OHSS and lipid metabolism has rarely been reported and the relative effect of lipid metabolism on OHSS demands further examination. We analyzed 233 cases with moderate and severe OHSS receiving hospitalization after in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycles and compared the degree and results of OHSS occurred in the two groups divided based on the presence or absence of dyslipidemia during ART, aiming to offer some insights on the treatment and prevention of OHSS
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