Severe ovarian hyperstimulation syndrome following gonadotropin releasing hormone agonist trigger and freeze all approach in GnRH antagonist protocol

Two case reports are presented, in which GnRH triggering and the freeze-all approach in a GnRH antagonist protocol resulted in the development of severe OHSS, requiring hospitalization and peritoneal drainage.

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Authors

Human Mousavi Fatemi, M.D., Ph.D., Biljana Popovic-Todorovic, M.D., Ph.D., Peter Humaidan, M.D., D.M.Sc., Shahar Kol, M.D., Ph.D., Manish Banker, M.D., Paul Devroey, M.D., Ph.D., Juan Antonio García-Velasco, M.D., Ph.D.

Volume 101, Issue 4, Pages 1008-1011

Abstract

Objective:

To report two cases with GnRH agonist triggering and a freeze-all approach in a GnRH antagonist protocol resulting in the development of severe ovarian hyperstimulation syndrome (OHSS), requiring hospitalization and peritoneal drainage.

Design:

Two case reports.

Setting:

A tertiary referral center and an obstetrics and gynecology department of a hospital.

Patient(s):

Case 1 and case 2: severe OHSS with abdominal distension, ascites development, and hemoconcentration.

Intervention(s):

Case 1 and case 2: diagnosed by clinical, hematologic, and ultrasound findings. Hospitalization, IV infusion, and peritoneal drainage.

Main Outcome Measure(s):

Symptomatic treatment and prevention of further complication.

Result(s):

Complete recovery.

Conclusion(s):

Two cases of severe OHSS after GnRH agonist trigger in a GnRH antagonist protocol without the administration of any hCG for luteal-phase support. Clinicians have to be aware that even the sequential approach to ovarian stimulation with a freeze-all attitude does not completely eliminate OHSS in all patients.

Read the full text at: http://www.fertstert.org/article/S0015-0282(14)00050-8/fulltext


Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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