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Avoidance of cancellation of potential hyperstimulation cycles by conversion to in vitro fertilization-embryo
1In Vitro Fertilization/Embryo Transfer Unit, Tel Aviv Sourasky Medical Center, Israel.
Objective:
The study was undertaken to minimize the rate of ovarian hyperstimulation and to avoid cancellation of human treatment cycles in women treated with human menopausal gonadotropin (hMG) for induction of ovulation.
Setting:
Patients were treated in the fertility clinic and in vitro fertilization unit of our institution, which is a government, university-affiliated hospital.
Patients:
Ninety anovulatory patients were treated with hMG. Of these, 12 were at high risk for ovarian hyperstimulation. The criteria for potential ovarian hyperstimulation syndrome were rising excessive 17 beta-estradiol levels of greater than 1,500 pg/mL in the presence of multiple follicles with a mean diameter greater than 15 mm. These patients were transferred for continuation of treatment to our in vitro fertilization-embryo transfer (IVF-ET) unit.
Interventions:
The patients underwent ova retrieval by the ultrasonically guided transvaginal approach.
Results:
Of the 12 patients, 5 conceived (41.6%). Two patients had a mild ovarian hyperstimulation syndrome, and 1 had a moderate syndrome and was hospitalized for observation for 48 hours.
Conclusion:
In view of the results, we suggest that IVF-ET should be considered in cases in which ovarian hyperstimulation syndrome is imminent, rather than withhold human chorionic gonadotropin and cancelling the treatment cycle.