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Curr Med Sci 2019 Apr 23;39(2):278-284. Epub 2019 Apr 23.

Center for Reproductive Medicine, Department of Gynecology and Obstetrics, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.

This observational study included 21 patients at remarkably high risk of ovarian hyperstimulation syndrome (OHSS), characterized by more than 30 follicles measuring ≥11 mm in diameter on trigger day and/or pre-trigger peak estradiol exceeding 10 000 pg/mL, which was also the feature of women with established severe early OHSS followed by gonadotrophin-releasing hormone agonist (GnRHa) trigger and freeze-all policy that previously have been reported. All patients received a second dose of GnRHa 12 h after the first GnRHa trigger combined with administration of GnRH antagonist at 0.25 mg/day for a period of 3 days from the day of oocyte retrieval onwards. Read More

Eur J Obstet Gynecol Reprod Biol 2019 Mar 11;237:57-63. Epub 2019 Mar 11.

The French Public Health Agency, Non-Communicable Disease and Trauma Division, Saint-Maurice, France.

Objectives: To determine whether the risk of thromboembolic complications is higher in women following unsuccessful fertility treatment (FT) and in pregnant women following successful FT, and whether the risk differs according to FT type.

Study Design: This is an observational prospective cohort study. All French women aged 18-45 years who received FT between 2013 and 2015 were selected from the French health insurance claim database which registers healthcare consumption for the entire French population. Read More

Arch Gynecol Obstet 2019 Apr 19. Epub 2019 Apr 19.

Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, 100034, People's Republic of China.

Purpose: Ovarian hyperstimulation syndrome (OHSS) is a serious complication of assisted reproductive technology (ART) treatment. However, there are limited data regarding the ability of the luteal GnRH antagonist cetrorelix to reduce the incidence of moderate and severe OHSS, and the mechanism remains unclear. Thus, we designed a study to assess the effectiveness of cetrorelix to prevent early moderate and severe OHSS in high-risk patients undergoing controlled ovarian stimulation for IVF/ICSI. Read More

Syst Biol Reprod Med 2019 Apr 19:1-9. Epub 2019 Apr 19.

b Division of Biotechnology , College of Life Sciences and Biotechnology, Korea University , Seongbuk-gu , Seoul , Republic of Korea.

In vitro maturation (IVM) has evolved as a clinical treatment option in assisted reproductive technology. However, the poor developmental potential of germinal vesicle (GV)-stage oocytes is still suboptimal. This study's objective was to evaluate the effect of a microvibration culture system (MVC) during IVM and/or in vitro culture (IVC) on the clinical outcomes and the embryonic development potential of human GV-stage oocytes collected from human chorionic gonadotropin (HCG)-primed IVM and fertilization-embryo transfer (IVM/F-ET) cycles of patients with polycystic ovaries (PCO). Read More

Acta Obstet Gynecol Scand 2019 Apr 16. Epub 2019 Apr 16.

Women's Health and Perinatology Research Group, Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromsø, Norway.

Introductio: High levels of anti-Mullerian hormone and a high antral follicle count in women with polycystic ovary syndrome, reflecting increased ovarian antral follicles, predisposes them to have a high number of retrieved oocytes at in-vitro fertilisation (IVF)/ intra-cytoplasmic sperm injection (ICSI) and an increased risk of ovarian hyperstimulation syndrome. Inositols, which act as insulin sensitizers have the potential to alter folliculogenesis and the functional ovarian reserve with subsequent benefits to reproductive outcomes following IVF/ICSI treatment. Published literature is however unable to provide definitive evidence of its efficacy. Read More

Reprod Biol Endocrinol 2019 Apr 12;17(1):37. Epub 2019 Apr 12.

Reproductive Medical Center, The First Affiliated Hospital of Zhengzhou University, 450052, Zhengzhou, People's Republic of China, Zhengzhou No. 1 construction east road, He'nan Province, China.

Background: Ovarian hyperstimulation syndrome (OHSS) is a common and severe complication for patients undergoing IVF/ICSI-ET. Melatonin widely participates in the regulation of female reproductive endocrine activity. However, whether melatonin participates in the progression of OHSS is largely unknown. Read More

Gynecol Endocrinol 2019 Apr 11:1-4. Epub 2019 Apr 11.

c Department of Obstetrics and Gynecology, Faculty of Medicine , Ankara University , Ankara , Turkey.

While luteinizing hormone (LH) activity is believed to play a role in follicle maturation, human chorionic gonadotropin (hCG) might play an important role in implantation process. We aimed to investigate whether addition of human menopausal gonadotropin (hMG) in recombinant-follicle-stimulating hormone (r-FSH) started GnRH antagonist controlled ovarian hyperstimulation (COH) cycles might enhance implantation rate and improve in vitro fertilization (IVF) success. A total of 246 patients undergoing GnRH antagonist IVF cycles were analyzed. Read More

Gynecol Endocrinol 2019 Apr 7:1-6. Epub 2019 Apr 7.

a Department of Pediatrics , The First Affiliated Hospital of Wenzhou Medical University , Wenzhou , China.

Preterm ovarian hyperstimulation syndrome (POHS) is a rare condition with only a few reported cases. The objective of this study is to investigate the clinical characteristics of 21 POHS cases (seven from China and 14 from the literature). Suspected patients (n = 7) were referred for further confirmation and data on demographics, family history, clinical manifestations (edema developed in the vulva, the hypogastric site and the upper leg), serum and sonographic assessments (ovarian cyst/cysts, gonadotropins, and estradiol levels), the natural course of patients were documented. Read More

Emerg Med Clin North Am 2019 May;37(2):239-249

Department of Obstetrics and Gynecology, Washington University in St. Louis, 660 South Euclid, Mailbox 8064-37-905, Saint Louis, MO 63110, USA.

Although only accounting for a small percentage of infants born in the United States each year, assisted reproductive technology (ART) has become a more common means of conception since the first in vitro fertilization baby was born in 1978. An understanding of the ART process, medications, and complications is becoming essential for emergency medicine practice. Much of the surveillance data focuses on ART complications that are likely to be less relevant in the acute care setting, but ovarian hyperstimulation syndrome, ectopic pregnancy, and ovarian torsion are 3 diagnoses with high potential morbidity and mortality that emergency physicians should not miss. Read More

Gynecol Endocrinol 2019 Apr 2:1-6. Epub 2019 Apr 2.

d Department of Anesthesiology and Critical Care , State Budgetary Healthcare Institution of Moscow Region, M.F. Vladimirskiy Moscow's Regional Research Clinical Institute , Moscow , Russian Federation.

To analyze the management of severe ovarian hyperstimulation syndrome based on aspects of its etiology and pathogenesis a systematic review of the literature was done. An evaluation of clinical trials, meta-analysis, case-reports and reviews assessing the management of different conditions related to ovarian hyperstimulation syndrome was made using the following data sources: MEDLINE Pubmed (from 1966 to July 2018) and the Cochrane Controlled Clinical Trials Register, Embase (up to July 2018). The role of intra-abdominal hypertension in the development of the severe forms of ovarian hyperstimulation syndrome and its complicated outcomes was assessed. Read More

Fertil Steril 2019 Apr;111(4):722-733

IVIRMA Madrid, Madrid, Spain; Department of Gynecology and Obstetrics, Rey Juan Carlos University, Madrid, Spain.

Objective: To evaluate the effectiveness of corifollitropin alfa in improving the success of IVF.

Design: Systematic review and meta-analysis.

Setting: Not applicable. Read More

J Paediatr Child Health 2019 Mar 28. Epub 2019 Mar 28.

Department of Biomedical Sciences and Human Oncology, Pediatric Section, University "A. Moro" of Bari, Bari, Italy.

Case Rep Womens Health 2019 Apr 9;22:e00106. Epub 2019 Mar 9.

Department of Obstetrics and Gynecology, University Hospital Merkur, Ivana Zajca 19, 10000 Zagreb, Croatia.

Heterotopic pregnancy followed by ovarian hyperstimulation syndrome and paralytic ileus are rare and potentially fatal complications associated with assisted reproduction. A 37-year-old nulliparous woman, after in-vitro fertilization and embryo transfer, presented to the gynaecology department with severe abdominal distension, diffuse abdominal pain and vaginal bleeding. Transvaginal ultrasound examination revealed an intrauterine pregnancy, with both ovaries enlarged, measuring 10cmx10cm, with free fluid in the pouch of Douglas. Read More

Reprod Biomed Online 2019 May 21;38(5):711-723. Epub 2018 Dec 21.

Shady Grove Fertility Reproductive Science Centre, Rockville MD, USA.

Research Question: How does oocyte cohort size affect IVF treatment outcomes?

Design: Retrospective cohort analysis of 10,193 fresh autologous oocyte retrievals among good-prognosis patients <35 years from 2009 to 2015. The primary outcome was live birth from a fresh transfer; secondary outcomes included cumulative live birth potential from the retrieved cohort and frequency of severe ovarian hyperstimulation syndrome (OHSS).

Results: Live birth per fresh transfer increased as the oocyte cohort increased up to 11-15 oocytes, then plateaued. Read More

Am J Obstet Gynecol 2019 Mar 22. Epub 2019 Mar 22.

Center for Reproductive Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 845 Lingshan Road, Shanghai 200135, P.R. China; Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, 845 Lingshan Road, Shanghai 200135, P.R. China. Electronic address:

Objective: With a high incidence of insulin resistance, central obesity and dyslipidemia, polycystic ovary syndrome (PCOS) women are susceptible to metabolic syndrome (MetS). Our objective was to explore whether MetS had an effect on overall female fertility and in vitro fertilization (IVF) outcomes in PCOS infertile women.

Methods: This was a secondary analysis of a multicenter randomized trial in 1508 PCOS women, which was originally designed to compare live birth rate after fresh embryo transfer vs. Read More

Reprod Biomed Online 2019 May 23;38(5):816-824. Epub 2018 Dec 23.

Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Centre for Genomic Research, University of Modena and Reggio Emilia, Modena, Italy. Electronic address:

Research Question: What is the cumulative effect of two follicle-stimulating hormone receptor (FSHR) mutations in spontaneous ovarian hyperstimulation syndrome (sOHSS) pathogenesis? Are these mutations in the mono- or biallelic state?

Design: Two FSHR mutations were found in a pregnant patient affected by sOHSS with no predisposing conditions. While the p.Asn106His mutation is novel, the p. Read More

Taiwan J Obstet Gynecol 2019 Mar;58(2):255-260

Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address:

Objective: Ovarian hyperstimulation syndrome (OHSS) is a major complication of assisted reproductive technologies (ART). Polycystic ovary syndrome (PCOS) is a risk factor for OHSS. The aim of this randomized clinical trial (RCT) was to study the effect of low-dose aspirin (LDA) on the development of OHSS and ART outcomes in PCOS during ART. Read More

Taiwan J Obstet Gynecol 2019 Mar;58(2):234-238

Department of Reproductive Endocrinology and Infertility, Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey.

Objective: To evaluate the effect of the GnRH antagonist on gonadotropin ovulation induction in women with PCOS.

Materials And Methods: A total of 175 intrauterine insemination (IUI) cycles in women with polycystic ovary syndrome (PCOS) were included in the study. Women in the control group (n = 87) underwent controlled ovarian stimulation (COS) with recombinant follicle stimulating hormone (r-FSH) only, while women in the study group (n = 88) were administered r-FSH plus cetrorelix. Read More

Taiwan J Obstet Gynecol 2019 Mar;58(2):192-195

Institute of Sciences in Human Reproduction "Vida", León, Mexico. Electronic address:

Objective: In this study, we report an experience of 59 natural-cycle IVF combined with in vitro oocyte maturation (IVF/M) cycles in patients with PCOS requiring IVF recruited based on limitations to afford a conventional IVF treatment in a 9-years period. Results of IVF/M were compared with 164 cycles of IVF in PCOS patients.

Material And Methods: In IVF/M cycles only hCG priming was used before oocyte recovery, with in vitro maturation of immature oocytes in a commercial medium. Read More

J Pediatr Adolesc Gynecol 2019 Mar 20. Epub 2019 Mar 20.

Emory Reproductive Center. Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, 550 Peachtree Street. Suite 1800, Atlanta, Georgia 30308, USA.

Study Objective: To describe oocyte cryopreservation (OC) cycles in adolescent women (<20 years of age) performed at Society for Assisted Reproductive Technology (SART) member clinics in the United States from 2012 - 2016 DESIGN: Retrospective cohort study SETTING: Not Applicable PARTICIPANTS: OC cycles from the Technology Clinic Outcome Reporting System (SART CORS) database INTERVENTIONS: OC cycles from 2012-2016 among adolescent women were compared to cycles in older women.

Main Outcome Measure: Number of oocytes retrieved RESULTS: From 2012-2016, oocyte cryopreservation cycles in women <20 years of age accounted for 1.5% of oocyte cryopreservation cycles in all women. Read More

Hum Reprod Open 2019 5;2019(2):hoz004. Epub 2019 Mar 5.

Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology Sydney, Sydney NSW, Australia.

Study Question: What is the cumulative live birth rate following a 'freeze-all' strategy compared with a 'fresh-transfer' strategy?

Summary Answer: The 'freeze-all' strategy resulted in a similar cumulative live birth rate as the 'fresh-transfer' strategy among high responders (>15 oocytes retrieved) but did not benefit normal (10-15 oocytes) and suboptimal responders (<10 oocytes).

What Is Known Already: Frozen-thawed embryo transfer is associated with a decreased risk of adverse obstetric and perinatal outcomes compared with fresh embryo transfer. It is unclear whether the 'freeze-all' strategy should be offered to all women undergoing ART treatment. Read More

Hum Reprod Open 2019 27;2019(1):hoz003. Epub 2019 Feb 27.

The Fertility Clinic 4071, Rigshospitalet, Blegdamsvej 9, Copenhagen, Denmark.

Study Question: Does an individualized serum anti-Müllerian hormone (AMH) based FSH dosing algorithm used in a GnRH antagonist protocol increase the proportion of patients with an intended number of oocytes (5-14) retrieved compared with a standard regimen?

Summary Answer: The AMH-based individualized algorithm did not increase the proportion of patients with an intended oocyte retrieval.

What Is Known Already: Individualizing treatment for ovarian stimulation by serum AMH or antral follicle count can theoretically improve the ratio between benefits and risks. Current data suggest that there may be a reduced risk of ovarian hyperstimulation syndrome (OHSS), but without improved pregnancy or live birth rates. Read More

J Obstet Gynaecol 2019 Mar 20:1-8. Epub 2019 Mar 20.

c Department of Biochemistry , Firat University School of Medicine , Elazig , Turkey.

This study aimed to evaluate the effects of coasting, cabergoline and clarithromycin in a rat ovarian hyperstimulation syndrome (OHSS) model. The 42 female Wistar rats were divided into seven groups: control, OHSS (was given 10 IU of pregnant mare serum gonadotropin for 4 consecutive days from day 22 and 30 IU hCG on the fifth day to induce OHSS ), coasting (hCG was applied on the 27th day after gonadotropin injections and the rats were decapitated on the 28th day), Cabergoline (100 mg/kg/d) and clarithromycin (100 mg/kg/d) were given (on the 26th day) with a short-term supplementation (on the 26th day) and long-term supplementation (from the 22nd to the 26th day) groups. The rats were decapitated on the 27th day. Read More

Expert Rev Endocrinol Metab 2019 Mar 4:1-12. Epub 2019 Mar 4.

a Centro de Investigaciones Endocrinológicas "Dr. César Bergadá" (CEDIE), CONICET - FEI - División de Endocrinología , Hospital de Niños Ricardo Gutiérrez , Buenos Aires , Argentina.

Introduction: Originally limited to the assessment of disorders of sex development, anti-Müllerian hormone (AMH) measurement has more recently been extended to several conditions affecting the reproductive axis in males and females. Follicle-stimulating hormone (FSH) regulation of gonadal function has been extensively studied, but its role on AMH production has been explored only recently. Areas covered: We addressed the relationship between FSH action on the gonads and the usefulness of AMH as a marker in conditions affecting the reproductive axis. Read More

Gynecol Endocrinol 2019 Mar 16:1-6. Epub 2019 Mar 16.

c Biosearch Life , Granada , Spain.

The purpose of this study was to evaluate the effect of two doses of D-chiro-inositol (DCI) in combination with Myo-inositol (MYO) in women with PCOS undergoing ICSI. This was a multicenter controlled, randomized, double-blind parallel group study with two MYO-DCI formulations for 12 weeks. The study group (SG) was administered 550 mg of MYO + 150 mg of DCI twice daily; the control group (CG) was administered 550 mg of MYO + 13. Read More

Curr Opin Obstet Gynecol 2019 Feb 21. Epub 2019 Feb 21.

IVI Middle-East Fertility Clinic, Abu Dhabi, UAE.

Purpose Of Review: The aim of this review is to summarize the different aspects of luteal phase deficiency in IVF treatment and the possibilities of individualized luteal phase support.

Recent Findings: After the application of human chorionic gonadotrophin (hCG) for final oocyte maturation, the vaginal route for progesterone administration is sufficient to maintain an adequate luteal phase support. New data point toward the possibility of oral medication; however, those data have yet to be confirmed in larger studies. Read More

Zhong Nan Da Xue Xue Bao Yi Xue Ban 2019 Feb;44(2):158-163

Department of Reproductive Medical Center, Xiangya Hospital, Central South University, Changsha 410008, China.

Objective: To compare the cumulative live birth rates (CLBR) and the incidence of ovarian hyperstimulation syndrome (OHSS) between fresh embryo transfer (ET) and frozen ET (the freeze-all policy), when oocyte numbers are more than 15 in the first treatment of in vitro fertilization or intracytoplasmic sperm injection, and to evaluate the benefits of the freeze-all policy.
 Methods: We retrospectively analyzed clinical data of 2 842 patients whose oocytes numbers were more than 15, including 1 095 frozen ET patients and 1 747 fresh ET patients. The patients general data, a baseline features, CLBR, and the incidence of OHSS were compared between the 2 groups. Read More

Pharmacogenet Genomics 2019 Mar 8. Epub 2019 Mar 8.

Department of Translational Medicine, Molecular Genetic Reproductive Medicine, Clinical Research Centre, Lund University, Lund.

Objective: To study if the follicle-stimulating hormone receptor (FSHR) variant asparagine/serine in amino acid 680 (N680S) can predict hypersensitivity to gonadotropins in women undergoing assisted reproduction.

Patients And Methods: In this retrospective study, 586 women undergoing their first in-vitro fertilisation treatment were enroled, and their FSHR N680S genetic variant was analysed. The main outcome measures were number of retrieved oocytes and any grade of ovarian hyperstimulation syndrome (OHSS). Read More

Lancet 2019 03 28;393(10178):1310-1318. Epub 2019 Feb 28.

Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China; The Key Laboratory of Reproductive Endocrinology of Ministry of Education, Jinan, China; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, China; Center for Reproductive Medicine, Ren Ji Hospital, Shanghai, China; School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Shanghai Key Laboratory of Assisted Reproduction and Reproductive Genetics, Shanghai, China. Electronic address:

Background: Elective single embryo transfer (eSET) has been increasingly advocated, but concerns about the lower pregnancy rate after reducing the number of embryos transferred have encouraged transfer of multiple embryos. Extended embryo culture combined with electively freezing all embryos and undertaking a deferred frozen embryo transfer might increase pregnancy rate after eSET. We aimed to establish whether elective frozen single blastocyst transfer improved singleton livebirth rate compared with fresh single blastocyst transfer. Read More

Ann Endocrinol (Paris) 2019 Apr 7;80(2):122-127. Epub 2019 Feb 7.

Department of neurosurgery, hôpital La Timone, Assistance publique-Hôpitaux de Marseille (AP-HM), Marseille, France; Aix-Marseille université, institut national de la santé et de la recherche médicale (Inserm), U1251, Marseille medical genetics (MMG), Marseille, France.

The authors reported 2 cases of functioning gonadotroph pituitary adenoma (FGPA) revealed by an ovarian hyperstimulation syndrome (OHSS) in young women. In the first case, OHSS was observed after GnRH analog injection. Pelvic echography revealed multiple voluminous ovarian cysts. Read More

Hum Reprod 2019 Apr;34(4):679-688

Department of Obstetrics and Gynaecology, Fertility Clinic Section 455, Hvidovre University Hospital, Hvidovre, Copenhagen, Denmark.

Study Question: What are the attitudes towards different aspects of a freeze-all strategy and elective frozen embryo transfer (eFET) in comparison with fresh embryo transfer in assisted reproductive technology treatment among female and male patients before and after their first ART treatment cycle in a public health care setting?

Summary Answer: Despite concerns about the delay in embryo transfer associated with eFET, nearly 60% of the participants were in favor of eFET compared with fresh embryo transfer assuming that the clinical pregnancy rate was equivalent.

What Is Known Already: Vitrification and blastocyst transfer have considerably improved success rates after FET with ongoing pregnancy rates in frozen cycles approaching those seen in fresh treatment cycles. Furthermore, the risk of ovarian hyperstimulation syndrome (OHSS) is essentially eliminated in FET cycles, and FET may be beneficial to the endometrial and fetal development because a hormonal environment mirroring the natural cycle is enabled. Read More

Gynecol Endocrinol 2019 Feb 26:1-4. Epub 2019 Feb 26.

a Department of Obstetrics and Gynecology , Alma Mater Studiorum-University of Bologna , Bologna , Italy.

Spontaneous hyperstimulation syndrome (spOHSS) is a rare event in pregnancies following natural conception. Only a few cases are reported in the scientific literature and result associated with massive ovarian enlargement with multiple cysts, dehydration, and fluid accumulation in the "third space". We report a novel case of spOHSS in a naturally conceived singleton pregnancy. Read More

Am J Case Rep 2019 Feb 23;20:238-241. Epub 2019 Feb 23.

University Medical Centre Maribor, Maribor, Slovenia.

BACKGROUND Ovarian hyperstimulation syndrome (OHSS) is a potentially serious complication of ovulation stimulation. Modest vulvar edema is frequently seen in a severe form of OHSS; however, cases of massive bilateral vulvar edema are rare and pathogenesis is uncertain. CASE REPORT We report a 31-year-old patient with massive vulvar edema and severe OHSS after IVF treatment with GnRH antagonist and gonadotropins. Read More

J Hum Reprod Sci 2018 Oct-Dec;11(4):348-352

Southend Fertility and IVF Centre, New Delhi, India.

Context: Increased circulating insulin levels contribute to hyperandrogenism in polycystic ovarian syndrome (PCOS) which causes a derangement in folliculogenesis, thus contributing to polycystic morphogenesis of the ovaries and a higher than normal anti-Mullerian hormone (AMH). A high AMH is an indicator of either stubborn anovulation or a predictor of ovarian hyperstimulation syndrome. Hence, it is postulated that the use of insulin sensitizers will reduce insulin resistance, hyperandrogenism, and subsequently serum AMH levels and will convert anovulatory cycles to ovulatory. Read More

Am J Obstet Gynecol 2019 Feb 8. Epub 2019 Feb 8.

Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Columbia University Medical Center, New York, NY.

Background: Ovarian hyperstimulation syndrome is a potentially life-threatening clinical condition.

Objective: The objective of this study was to evaluate risk factors for life-threatening complications for patients with severe ovarian hyperstimulation syndrome in a United States nationwide sample.

Materials And Methods: Ovarian hyperstimulation syndrome admissions from 2002 to 2011 from the Nationwide Inpatient Sample were included in this study. Read More

Case Rep Womens Health 2019 Jan 23;21:e00096. Epub 2019 Jan 23.

Genesis Fertility, Division of Reproductive Endocrinology & Infertility at Maimonides Medical Center, 6010 Bay Pkwy., Brooklyn, New York, USA.

Objective: To present a case of abnormally trending hCG levels due to ovarian hyperstimulation syndrome (OHSS) and to portray the obscurities of this commonly used method for tracking early pregnancies.

Design: Case report.

Setting: Outpatient ART facility. Read More

Arch Gynecol Obstet 2019 Apr 6;299(4):1151-1158. Epub 2019 Feb 6.

Center for Reproductive Medicine, School of Medicine, RenJi Hospital, Shanghai Jiao Tong University, Shanghai, 200135, China.

Purpose: Melatonin is an important factor in regulating numerous processes in human female reproduction. The aim of the present study was to compare melatonin levels in the follicular fluid (FF) of ovarian hyperstimulation syndrome (OHSS) women with those of non-OHSS women undergoing in vitro fertilization (IVF)-embryo transfer and to evaluate the relationship between FF melatonin levels and IVF outcomes in these women.

Methods: We determined FF melatonin levels in 20 OHSS women and 23 non-OHSS women on oocyte retrieval day. Read More

Biomed Rep 2019 Feb 29;10(2):113-118. Epub 2018 Nov 29.

Department of Reproductive Medicine, Linyi People's Hospital, Linyi, Shandong 276003, P.R. China.

The aim of the present study was to evaluate the influence of a gonadotropin-releasing hormone (GnRH) antagonist compared with a GnRH agonist on fertilization (IVF) cycle outcome in reproductive women. The characteristics of treatment and outcomes of pregnancy were retrospectively compared between the antagonist (GnRH-A, antagonist group) and agonist (GnRH-a, agonist group) regimens. The area under the curve (AUC) of receiver operating characteristic (ROC) curves was also used to evaluate whether the endometrial thickness (cm), progesterone (P) level (ng/ml) and estradiol (E) level (pg/ml) on the day of human chorionic gonadotropin (hCG) administration (hCG day) had the ideal sensitivity and specificity for predicting clinical pregnancy. Read More

Hum Fertil (Camb) 2019 Feb 4:1-7. Epub 2019 Feb 4.

d Department of Immunology , Reproductive Immunology Research Center, Shahid Sadoughi University of Medical Sciences , Yazd , Iran.

This study determined the association between the levels of interleukin (IL)-17 and IL-23 in follicular fluid (FF), as well as their mRNA levels in cumulus cells from infertile women at risk for ovarian hyperstimulation syndrome (OHSS). In this case-controlled study, the control group (n = 40) was infertile women whose partners had male factor infertility, whereas the case group (n = 40) was infertile women at risk of OHSS. IL-17 and IL-23 concentrations in FF were measured using an enzyme-linked immunosorbent assay method, whereas the mRNA expression levels of IL-17 and IL-23 of cumulus cells were determined using RT-PCR. Read More

Reprod Biomed Online 2019 Apr 23;38(4):528-537. Epub 2018 Dec 23.

Ferring Pharmaceuticals, US Development, Parsippany, NJ 07054, USA.

Research Question: Is individualization of dosing with follitropin delta in sequential ovarian stimulation cycles an effective preventive strategy for ovarian hyperstimulation syndrome risk? If so, for which patients does an individualized strategy provide the greatest OHSS risk reduction and/or the need for additional preventive interventions?

Design: A secondary analysis of three ovarian stimulation cycles in IVF/intracytoplasmic sperm injection patients included in one randomized, assessor-blinded trial comparing two recombinant FSH preparations (ESTHER-1, NCT01956110), and a second trial in women undergoing up to two additional cycles (ESTHER-2, NCT01956123). Of 1326 women (aged 18-40 years) randomized and treated with follitropin delta or alfa in cycle 1, 513 continued to cycle 2 and 188 to cycle 3. Follitropin delta and alfa doses were maintained/adjusted according to ovarian response in the previous cycle. Read More

Hum Reprod 2019 Mar;34(3):491-505

Aristotle University of Thessaloniki, Medical School, Unit for Human Reproduction, 1st Department of Obstetrics and Gynecology, Thessaloniki, Greece.

Study Question: Does the outcome of the comparison of live birth rates between the first frozen embryo transfer (ET) (in a freeze-only cycles strategy, i.e. frozen ET group) and a fresh embryo transfer (fresh ET group) differ considering the type of ovarian response?

Summary Answer: Α significantly higher probability of live birth is present in high, but not normal, responders, after the first frozen ET in a freeze-only cycle strategy as compared to a fresh ET. Read More

Reproduction 2019 04;157(4):R127-R142

Hospital Universitario Dexeus, Barcelona, Spain.

A narrative review of the management of controlled ovarian stimulation in patients undergoing preimplantation genetic testing is presented. An electronic search was performed to identify research publications that addressed ovarian stimulation and preimplantation genetic testing published until December 2017. Studies were classified in decreasing categories: randomized controlled trials, prospective controlled trials, prospective non-controlled trials, retrospective studies and experimental studies. Read More

J Ovarian Res 2019 Jan 26;12(1). Epub 2019 Jan 26.

Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Center for Advanced Reproductive Services, University of Connecticut School of Medicine, Farmington, CT, 06030, USA.

Background: Ovarian hyperstimulation syndrome remains a serious complication during in vitro fertilization cycles if high dose human chorionic gonadotropin (hCG) is used to trigger ovulation in high responder patients. Though much of this risk is mitigated with trigger using gonadotropin releasing-hormone (GnRH) agonist alone, it may result in lower birth rates. GnRH-agonist trigger and adjuvant low dose hCG has been proposed to improve birth rates, but timing of this hCG support to corpus luteum function has never been fully described. Read More

Panminerva Med 2019 Mar;61(1):97-99

American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.

Panminerva Med 2019 Mar;61(1):42-51

The Fertility Clinic Skive Regional Hospital, Skive, Denmark.

Ovulation trigger (OT) strategy is a cornerstone in modern patient-tailored in-vitro fertilization treatment, securing the optimal number of mature oocytes retrieved without compromising fertilization, embryo development and euploidy rates. Moreover, the OT strategy is taken into consideration before selecting fresh or frozen embryo transfer (freeze-all) to obtain optimal reproductive outcomes while maintaining a low risk of ovarian hyperstimulation syndrome. Several OT agents have been proposed, however, the most common agents used in modern IVF are human chorionic gonadotropin and gonadotropin-releasing hormone agonist. Read More

Endocrinology 2019 Mar;160(3):699-715

Fertility & Research Centre, School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.

Polycystic ovary syndrome (PCOS) is a common cause of female infertility. Hyperandrogenism is both a major symptom and key diagnostic trait of PCOS; however, the direct impact of this androgen excess on ovarian dynamics is unclear. By combining a DHT-induced PCOS mouse model with an ex vivo follicle culture system, we investigated the impact of hyperandrogenism on ovarian function. Read More

Cochrane Database Syst Rev 2019 01 16;1:CD010290. Epub 2019 Jan 16.

Center for Reproductive Medicine, Amsterdam UMC, Free Medical University, De Boelelaan 1105, Amsterdam, Netherlands, 1081 HV.

Background: Ovulation induction with follicle stimulating hormone (FSH) is a second-line treatment in women with polycystic ovary syndrome (PCOS) who do not ovulate or conceive on clomiphene citrate.

Objectives: To compare the effectiveness and safety of gonadotrophins as a second-line treatment for ovulation induction in women with clomiphene citrate-resistant polycystic ovary syndrome (PCOS), and women who do not ovulate or conceive after clomiphene citrate.

Search Methods: In January 2018, we searched the Cochrane Gynaecology and Fertility Group Specialised Register of Controlled Trials, CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL, the World Health Organisation clinical trials register, Clinicaltrials. Read More

Int J Fertil Steril 2019 Apr 6;13(1):38-44. Epub 2019 Jan 6.

Department of Obstetrics and Gynaecology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.

Background: In vitro maturation (IVM) is an artificial reproductive technology in which immature oocytes are harvested from the ovaries and subsequently will be matured in vitro. IVM does not require ovarian hyperstimulation (OH) and thus the risk of ovarian hyperstimulation syndrome (OHSS) is avoided. In this study, we assessed the live birth rate per initiated IVM cycle in women eligible for in vitro fertilization/intracytoplasmic sperm injection (IVF/ ICSI) and at risk for OHSS. Read More

Emerg Radiol 2019 Apr 10;26(2):205-219. Epub 2019 Jan 10.

Department of Radiology, Henry Ford Hospital, Detroit, MI, USA.

Over the past 40 years since the first in vitro fertilization was performed, both the role of assisted reproductive technology (ART) in establishing viable pregnancy as well as the available treatment options have expanded enormously. Annually in the USA, nearly 2% of pregnancies now employ some form of ART assistance, with in vitro fertilization (IVF) being the most commonly utilized methodology. Both maternal and fetal risks are elevated in ART pregnancies, the latter including adverse outcome due to both increased gestational number as well as advanced maternal age. Read More

Gynecol Endocrinol 2019 Jan 7:1-2. Epub 2019 Jan 7.

a Infertility and IVF Unit , Barzilai University Medical Center , Ashkelon , Israel.

This study aims to report a case of early, severe ovarian hyperstimulation syndrome (OHSS) following GnRH agonist trigger for final oocyte maturation despite luteal support with a GnRH agonist. Contrary to the claim that luteal support using a GnRH agonist eliminates the risk for OHSS in high-risk patients, this report alerts practitioners to the risk of severe OHSS development despite GnRH agonist luteal support in patients receiving GnRH antagonist protocol with GnRH agonist triggering and cautions the practitioners to consider other measures of OHSS prevention. Read More