A SURVEY OF In-vitro FERTILISATION PATIENTS WITH OVARIAN HYPERSTIMULATION SYNDROME: RISK FACTOR IDENTIFICATION
P. OSEMWENKHA ABIEYUWA
Department of Obstetrics and Gynaecology, College of Medical Sciences, University of Benin, Benin- City, Nigeria
N. OMO-IDONIJE JOY
Department of Obstetrics and Gynaecology, College of Medical Sciences, University of Benin, Benin- City, Nigeria
A. OSAIKHUWUOMWAN JAMES *
Department of Obstetrics and Gynaecology, College of Medical Sciences, University of Benin, Benin- City, Nigeria
E. AZIKEN MICHAEL
Department of Obstetrics and Gynaecology, College of Medical Sciences, University of Benin, Benin- City, Nigeria
*Author to whom correspondence should be addressed.
Abstract
Background: Ovulation induction in the treatment of infertility is desirable. Ovarian hyperstimulation syndrome (OHSS) is a possible iatrogenic complication and could be catastrophic.
Objective: To identify the possible risk factors associated with the occurrence of OHSS amongst women accessing IVF treatment.
Methods: A review of all IVF treatment cycle between January 2011 and December 2012. From the cohort those with OHSS were identified and selected for analysis.
Results: Analysis of probable risk factors for OHSS showed that majority (over 60%) of the women that had OHSS were aged 30 years and below. The presence of PCOS and PCO-like characteristics accounted for about 80% of the OHSS cases. Other risk factors were obesity (over 40%), higher amount of gonadotrophins used for stimulation and increasing number of follicles at retrieval. Presence of more than fifteen (15) follicles at time of retrieval constituted a significant cut off for development of OHSS. The incidence rate of developing OHSS was calculated to be 2.3% per year.
Conclusion: Identified risk factors were younger age, presence of PCOS/PCO-like characteristics, obesity, presence of multiple follicles at oocyte retrieval and exposure to higher doses of gonadotrophins. Women with the aforementioned should have measures instituted to mitigate OHSS. Astute patient selection with individualization of stimulation regime is advocated.
Keywords: Infertility, OHSS, in-vitro fertilization, ovulation induction, gonadotrophins