Skip to main content
Log in

Early timed follicular aspiration prevents severe ovarian hyperstimulation syndrome

  • Clinical Assisted Reproduction
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose: Early timed follicular aspiration (ETFA) of one ovary 10–12 hr after administration of chorionic gonadotropin (hCG) is an attempt to prevent severe ovarian hyperstimulation syndrome (OHSS). After the introduction of early timed follicular aspiration ETFA of one ovary in IVF/ET cycles at high risk for severe OHSS, no cases of severe OHSS were registered in the Ljubljana IVF/ET program. In the period before preventive ETFA (1984–1992) there were 16 cases of severe OHSS of 4798 IVF/ET cycles followed by 577 clinical pregnancies. After the introduction of ETFA (1992–1993) there were no cases of severe OHSS of 2289 IVF/ET cycles followed by 364 clinical pregnancies.

Methods: We attempted to evaluate the significance of this observation by comparing two groups of female infertility IVF/ET cycles at high risk for severe OHSS. The occurrence of severe OHSS and clinical parameters in the two groups of IVF/ET cycles at high risk for severe OHSS were compared.

Results: In the group of 106 IVF/ET female infertility cycles at high risk of severe OHSS with preventive ETFA, there were no cases of severe OHSS. In the control group of 92 IVF/ET female infertility cycles at high risk for severe OHSS with normally timed follicular aspiration (NTFA) of both ovaries, severe OHSS occurred in 16 cases. The difference in the occurrence of severe OHSS between the two groups is highly significant (P<0.005), both in hMG/hCG- and in GnRHa/hMG/hCG-induced IVF/ET cycles. No difference in live birth rate (16 vs. 16%) between the two groups was noted.

Conclusions: Considering these results we conclude that ETFA is another successful option to decrease the incidence of severe OHSS in assisted reproduction. The preventive effect of follicular aspiration seems to depend on its timing.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Schenker J G: Prevention and treatment of ovarian hyperstimulation. Hum Reprod 1993;8:653–659

    PubMed  Google Scholar 

  2. Salat-Baroux J, Alvarez S, Antoine J M, Cornet D, Tibi Ch, Plachot M, Mandelbaum J: Treatment of hyperstimulation during in vitro fertilization. Hum Reprod 1990;5:36–39

    PubMed  Google Scholar 

  3. Sher G, Salem R, Feinman M, Dodge S, Zouves C, Knutzen V: Eliminating the risk of life endangering complications following overstimulation with menotropin fertility agents: A report on women undergoing in vitro fertilization and embryo transfer. Obstet Gynecol 1993;81:1009–1011

    PubMed  Google Scholar 

  4. Navot D, Bergh P A, Laufer N: Ovarian hyperstimulation syndrome in novel reproductive technologies: Prevention and treatment. Fertil Steril 1992;58:249–261

    PubMed  Google Scholar 

  5. Asch R H, Ivery G, Goldsman M, Frederick J L, Stone S C, Balmeceda J P: The use of intravenous albumin in patients at high risk for severe ovarian hyperstimulation syndrome. Hum Reprod 1993;8:1015–1020

    PubMed  Google Scholar 

  6. Amit A, Yaron Y, Peyser M R, David M P, Botchan A, Lessing J B: Repeated aspiration of ovarian follicles and early corpus luteum cysts in an in vitro fertilization programme reduces the risk of ovarian hyperstimulation syndrome in high responders. Hum Reprod 1993;8:1184–1186

    PubMed  Google Scholar 

  7. Meden-Vrtovec H, Tomaževič T: Preventing severe ovarian hyperstimulation syndrome in an in vitro fertilization/embryo transfer program. J Reprod Med 1995;40:37–40

    PubMed  Google Scholar 

  8. Tomaževič T, Meden-Vrtovec H: Early timed follicular aspiration (ETFA) of one ovary—protecting the development of ovarian hyperstimulation syndrome and providing high pregnancy rates in IVF/ET. 8th Congress on In Vitro Fertilization and Alternate Assisted Reproduction, Kyoto Japan—Abstracts. J Assist Reprod Genet 1993;10:94

    Google Scholar 

  9. Tomaževič T, Meden-Vrtovec H, Pompe-Tanšek M, Ribič-Pucelj M, Vogler A, Hren-Vencelj H, Bernjak I, Žemva Ž: The Ljubljana IVF/ET program—brief report. J Vitro Fert Embryo Transfer 1990;7:295–296

    Google Scholar 

  10. Tomaževič T, Meden-Vrtovec H, Ribič-Pucelj M, Pompe-Tanšek M, Vogler A, Kos D, Veble A, Valentinčič B: Ten years of IVF/ET at the University Women Hospital Ljubljana. Zdrav Vestn 1994;63:579–583

    Google Scholar 

  11. Schenker J G, Weinstein D: Ovarian hyperstimulation syndrome: A current survey. Fertil Steril 1978;30:255–268

    PubMed  Google Scholar 

  12. Hazout A, Porchier J, Frydman R: Une alternative a la reduction embryonnaire: la reduction folliculaire. Gynecologie 1984;66:220–224

    Google Scholar 

  13. Rabinowitz R, Laufer N, Schenker J G: Rate of ovarian hyperstimulation syndrome after high dose hMG for induction of ovulation in IVF cycles. 5th Congress on IVF-ET, Norfolk, CT, 1987, p 111 (abstract 5000)

  14. Navot D, Margalioth E J, Laufer N, Birkenfeld A, Relou A, Rosler A,et al. Direct correlation between plasma renin activity and severity of ovarian hyperstimulation syndrome. Fertil Steril 1987;48:57–61

    PubMed  Google Scholar 

  15. Laufer N, Grunfeld L, Garisi G J: In vitro fertilization.In Infertility: Comprehensive Text, Leibel MM (ed). Norwalk, CT, Appleton-Lange, 1990, pp 481–511

    Google Scholar 

  16. Friedman C I, Schmidt G E, Chang F E, Kim M H: Severe ovarian hyperstimulation following follicular aspiration. Am J Obstet Gynecol 1984;150:436–437

    PubMed  Google Scholar 

  17. Rizk B, Smitz J: Ovarian hyperstimulation syndrome after superovulation using GnRH agonists for IVF and related procedures. Hum Reprod 1992;7:320–327

    PubMed  Google Scholar 

  18. Aboulghar M A, Mansour R T, Serour G I, Elattar I, Amin Y: Follicular aspiration does not protect against the development of ovarian hyperstimulation syndrome. J Assist Reprod Genet 1992;9:238–243

    PubMed  Google Scholar 

  19. Golan A, Ron-El R, Herman A, Weinraub Z, Soffer Y, Caspi E: Ovarian hyperstimulation syndrome following D-Trp-6 luteinizing hormone-releasing hormone microcapsules and menotropin for in vitro fertilization. Fertil Steril 1988;50:912–916

    PubMed  Google Scholar 

  20. Asch R H, Li H P, Balmaceda J P, Weckstein L N, Stone S C: Severe ovarian hyperstimulation syndrome in assisted reproductive technology: Definition of high risk groups. Hum Reprod 1991;6:1395–1399

    PubMed  Google Scholar 

  21. Meden-Vrtovec H, Tomaževič T: Severe ovarian hyperstimulation syndrome in the IVF-ET program. ARTA 1992;3:347–353

    Google Scholar 

  22. Jamieson M E, Fleming R, Kader S, Ross K S, Yates R W S, Coutts J R T: In vivo and in vitro maturation of human oocytes: Effects on embryo development and polyspermic fertilization. Fertil Steril 1991;56:93–97

    PubMed  Google Scholar 

  23. Bouchard P: Facteurs de croissance et cytokines: role dans la maturation folliculaire et ovulation. Abstracts of Deuxiemes Journees Europeennes de la Societe Francaise de Gynecologie, Versailles, Oct 12–14, 1994

  24. Mori T, Fujiwara H, Hattori N, Honda T, Nakamura K, Adachi N, Hashii K, Kataoka N, Fukuoka M, Ueda M, Maeda M: Dual control of ovarian function through endocrine and immune system. IX World Congress on In Vitro Fertilization and Alternated Assisted Reproduction, Vienna, Austria, April 3–7 1995, pp 3–6

  25. Bergh P A, Navot D: Ovarian hyperstimulation syndrome: A review of pathophysiology. J Assist Reprod Genet 1992;9:429–438

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tomaževič, T., Meden-Vrtovec, H. Early timed follicular aspiration prevents severe ovarian hyperstimulation syndrome. J Assist Reprod Genet 13, 282–286 (1996). https://doi.org/10.1007/BF02070139

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02070139

Key words

Navigation