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oa The Outcome of In-Vitro Fertilization/Intracytoplasmic Sperm Injection (IVF/ICSI) Cycles Complicated by Moderate-Severe Ovarian Hyperstimulation Syndrome (OHSS)
- Source: Qatar Medical Journal, Volume 2002, Issue 2, Nov 2002, 15
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- 01 November 2002
Abstract
A retrospective study was used in the Fertility Clinic of the Department of Obstetrics & Gynecology, Tawam Hospital, Al Ain, Abu Dhabi, United Arab Emirates to determine the outcome of IVF/ICSI cycles complicated by OHSS.
Materials & Methods: In the period between January 1994 and August 2000, 3174 IVF/ICSI cycles were performed and 2918 cycles had reached embryo transfer, 564 women achieved pregnancy (19.33%). 92 women (3.15%) developed moderate-severe OHSS and were hospitalized and their medical and IVF records were reviewed. Supportive management whilst waiting for the condition to resolve spontaneously together with follow-up by ultrasound scan and blood tests was applied to all patients included in the study. Pregnancy test was performed 17 days after ovum pick-up.
Results: Ninety-two women developed moderate-severe OHSS, 37 women of them had a clinical pregnancy (40.2%). 51.4% were singletons and 48.6% were multiple pregnancies; including 13 sets of twins, 4 sets of triplets and one set of quadruplets. The miscarriage rate was 32.4% and the spontaneous fetal reduction rate was 16.6%. 25 women continued pregnancy (67.6%); eleven women had preterm delivery (44%), low birth weight rate was 44% and take home baby rate was 59.4%. The Cesarean section rate was 24%. Pregnancy-induced hypertension rate was only 8% and gestational diabetes 4%. There were no cases of ectopic pregnancy or placental abruption.
Conclusion: The pregnancy rate and the rate of multiple pregnancy, miscarriage, prematurity, low birth weight and Cesarean section rate are significantly higher than those reported previously for pregnancies conceived with the use of assisted reproductive techniques without the development of OHSS. The incidence of other obstetric complications such as pregnancy-induced hypertension, gestational diabetes, abruptio placentae and ectopic pregnancy are not significantly different.