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Embryo freezing for preventing Ovarian Hyperstimulation Syndrome
1Cardiff Assisted Reproduction Unit, University Hospital of Wales, Heath Park, Cardiff, Wales, UK, CF14 4XN. d-angeloa@cardiff.ac.uk
The Cochrane Database of Systematic Reviews
|June 22, 2002
Summary
Cryopreservation (embryo freezing) and intra-venous albumin show no significant difference in preventing ovarian hyperstimulation syndrome (OHSS). Insufficient evidence supports routine cryopreservation or the superiority of albumin over freezing for OHSS management in assisted reproduction.
Area of Science:
- Reproductive Medicine
- Gynecology
- Clinical Trials
Background:
- Ovarian hyperstimulation syndrome (OHSS) is a serious complication of assisted reproduction techniques (ART).
- It arises from excessive ovarian stimulation, leading to fluid shifts and hemoconcentration.
- The exact triggers for OHSS remain incompletely understood, but ovarian release of vasoactive substances under hCG stimulation is implicated.
Purpose of the Study:
- To compare the effectiveness of cryopreservation (embryo freezing) versus intravenous albumin for OHSS prevention.
- To evaluate elective cryopreservation of all embryos against fresh embryo transfer for OHSS prevention.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) identified through extensive literature searches.
- Included studies involved women undergoing superovulation in IVF/ICSI cycles.
- Data extraction and analysis followed Cochrane guidelines, comparing cryopreservation vs. albumin and elective cryopreservation vs. fresh transfer.
Main Results:
- Only two studies met the inclusion criteria.
- No significant differences were found between cryopreservation and intravenous albumin for any outcome.
- Similarly, no differences were observed between elective cryopreservation and fresh embryo transfer.
Conclusions:
- There is insufficient evidence to recommend routine cryopreservation for OHSS prevention.
- Evidence is also insufficient to determine the relative merits of intravenous albumin compared to cryopreservation.
- Further high-quality RCTs are needed to clarify optimal management strategies for OHSS in ART.