Human albumin is effective in prevention of severe OHSS

Severe OHSS is an iatrogenic, potentially life-threatening complication of controlled ovarian hyperstimulation. Intravenous human albumin, administered around the time of oocyte retrieval has been claimed to prevent development of this serious event. It was hypothesized that albumin acts through its osmotic pressure and through the binding and inactivation, at a critical time of the cycle, of an hCG-mediated factor secreted by the corpora lutea, that impedes capillary integrity and leads to the development of OHSS. The present article evaluates the available evidence in the medical literature whether albumin is effective in reducing the risk of severe OHSS. Several trials have been identified, most of them were retrospective and few were prospective randomized controlled trials. Although albumin prophylaxis cannot offer absolute protection, all three randomized placebo-controlled trials, that have been published so far, demonstrated a significant reduction in the incidence of severe OHSS.