Risk Factors and Method for Predicting Ovarian Hyperstimulation Syndrome (OHSS) in the In Vitro Fertilization Program

Abstract

Ovarian hyperstimulation syndrome (OHSS) is the most severe and life-threatening complication of assisted reproductive technologies (ART). OHSS is based on an excessive ovarian response to ovarian stimulation; however, the pathogenesis has not been fully understood yet. The most serious complications of OHSS are thromboembolic complications and ovarian torsion. The current study describes the risk factors for the development of ovarian hyperstimulation syndrome and proposes a method for individual prediction of the syndrome. This study was designed to investigate 671 treatment cycles in the IVF program for 2009-2018. All patients were divided into 2 groups. Group 1 (n=56) included women who developed OHSS during the IVF procedure. Group 2 (n=615) consisted of women who did not have this complication during the IVF procedure. All the observation and examination outcomes were entered into a specially developed questionnaire, and then into an MS Excel spreadsheet. The material was processed by variable statistics using Statistica 10.0. Analyzing of the recorded data revealed that the rate of OHSS was higher in the group of younger women, 30.76±3.67 years, in comparison with 32.78±4.40 years in the group of patients without OHSS (p<0.05). The analysis of the initial phase of the reproductive system has confirmed that the group of patients with OHSS had a higher level of prolactin, 462.84±191.56 mIU/L in comparison with 363.43±187.84 mIU/L, which corresponded to the group of women without OHSS (p<0.05). Patients with OHSS significantly less often had obesity, in 7.15±1.04% of cases, while none of the patients from the group without OHSS suffered from it (p<0.05). OHSS is the most severe iatrogenic complication of ART, therefore it is extremely important to consider risk factors and take timely preventive measures. This study has established a high relationship between the above risk factors and ovarian hyperstimulation syndrome and proposed a model for predicting this syndrome.