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Severe ovarian hyperstimulation syndrome: is it really preventable by prophylactic intravenous albumin?
G Ndukwe1, S Thornton, S Fishel
1Department of Obstetrics and Gynaecology, University Hospital, Queen's Medical Centre, Nottingham, United Kingdom.
Objective:
To evaluate the effectiveness of i.v. albumin in preventing severe ovarian hyperstimulation syndrome (OHSS) in patients at risk.
Design:
Retrospective review and data analysis.
Setting:
University-based tertiary referral center for assisted reproductive technologies (ART).
Patient(S):
Sixty women at high risk of developing severe OHSS after superovulation for ART.
Intervention(S):
One liter of albumin (4.5%) administered i.v. during oocyte retrieval and immediately afterward.
Result(S):
Of the 60 women who had prophylactic i.v. albumin, 5 (8%) developed severe OHSS, which led to hospitalization. Eight (13%) developed moderate OHSS. Forty-seven (78%) did not develop any symptoms. Four of the 5 women who developed severe OHSS had ET and 3 of them (75%) were pregnant (1 twin and 2 singletons).
Conclusion(S):
Intravenous albumin administered at oocyte retrieval does not prevent the occurrence of severe OHSS, especially in cases associated with pregnancy. It is important that clinicians are not lured into a false sense of security by the early report, full of promise, on the use of i.v. albumin to prevent severe OHSS.