Embryo freezing for preventing ovarian hyperstimulation syndrome

摘要: BACKGROUND: Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic potentially life threatening condition resulting from excessive ovarian stimulation. Its reported incidence varies 1% to 10% of in vitro fertilization (IVF) cycles. The factors leading this have not been completely explained. It seems likely that the release vasoactive substances, secreted by ovaries under human chorionic gonadotropin (hCG) stimulation plays a key role triggering syndrome. hallmark condition, massive shift fluid intra-vascular compartment third space profound depletion and hemoconcentration. OBJECTIVES: To evaluate (i) effectiveness cryopreservation (embryo freezing) for prevention OHSS when compared with intra-venous albumin infusion (ii) elective freezing ) all embryos fresh embryo transfer. SEARCH STRATEGY: Publications literature describe or may randomised controlled trials both management as consequence superovulation assisted reproduction techniques (ART) cycles were searched. Cochrane Menstrual Disorders Subfertility Review Group specialised register was In addition, MEDLINE (PUBMED 1985 2001), EMBASE (1985 CINHAL 2001) National Research Register searched SELECTION CRITERIA: Randomised (RCTs) which either used therapeutic approach included. participants women reproductive age who down regulated gonadotrophin-releasing hormone-analogue (GnRH-a), undergoing fertilization/intra-cytoplasmic sperm injection (IVF/ICSI) cycles. DATA COLLECTION AND ANALYSIS: Two reviewers, Mr N.N. Amso (NNA) Dr A. D'Angelo (ADA) scanned titles abstracts reports identified electronic searching order find relevant papers. One reviewer obtained copies full text articles made other details authors, institution, results discussion removed assess their eligibility inclusion. Then, reviewers extracted data independently using forms designed according guidelines. Disagreements resolved discussion. Additional information on trial methodology requested writing corresponding authors directly. interventions versus administration transfer. primary outcomes were: moderate severe nil/mild OHSS, clinical pregnancies/woman. secondary number oocytes retrieved, fertilized, transferred, frozen, multiple pregnancy rate, live birth admitted hospital inpatient outpatient time next menstrual period (resolution time). Statistical analysis performed accordance guidelines. MAIN RESULTS: Seventeen studies identified, two met our inclusion criteria. study included where (Shaker 1996) one transfer (Ferraretti 1999). When no difference found examined between groups. groups. REVIEWER'S CONCLUSIONS: This review has showed there insufficient evidence support routine relative merits cryopreservation.