Risk of ovarian hyperstimulation syndrome in infertile patients with PCOS treated by HP HMG

Abstract

Polycystic ovarian syndrome (PCOS) is the commonest endocrinopathy affecting women in reproductive age group. The prevalence may vary from 8.7% to 17% depending on clinical criteria used. PCOS in women having IVF presents multiple challenges ranging from a poor to an exaggerated response, poor fertilization, poor blastocyst conversion and ovarian hyperstimulation syndrome (OHSS). OHSS is at increased risk in PCOS patients receiving fertility treatments varying from mild to severe cases which can be life threatening. Aim of the study: The presence of OHSS in infertile PCOS patients who followed non-pituitary down regulation protocol by using HP HMG injections. Materials and methods: The study type was case series study. It was done in Lamis IVF center - Misurata / Libya during the period 1- 9 -2021 to 31- 8 -2022. 118 infertile patients with PCOS were randomly selected for the study. All patients were selected started ovulation induction with non-pituitary down regulation protocol using highly purified HMG injections. Results: The age of the patients ranges between 18 and 45 years with a mean age of 30 years. The mean number of retrieved oocytes was 19.33 ± 10. The study also showed that the mean number of mature oocytes picked up was 9.41 ± 5.5 with mean success of 77.6%. Hyperstimulation syndrome was reported only in one case (prevalence of 0.8%) which was mild (needed no admission). Regarding the embryo, the mean number of transfers was 2.36 ± 0.6 with two cases showed no fertilization and 82 cases were associated with poor sperm. Conclusion: In our study OHSS in PCOS patients treated by highly purified HMG injections developed in only one case which was mild (needed no admission).