Embryo freezing for preventing ovarian hyperstimulation syndrome

D’Angelo, Arianna; Amso, Nazar Najib

doi:10.1002/14651858.cd002806.pub2

Cited by 33 publications

(13 citation statements)

References 36 publications

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“…PCOS constitutes a high risk for the development of OHSS, and ~15% risk of developing severe OHSS (35, 39). A number of strategies have been used for preventing or decreasing the risk of OHSS including embryo cryopreservation with no transfer, IV albumin administration, GnRH antagonist protocol, dopamine agonists, low-dose aspirin, coasting and treatment with metformin (42–49). The most effective strategy to date is the use of GnRHa to trigger oocyte maturation, which virtually eliminates the occurrence of this potentially life threatening condition (33, 50).…”

Section: Discussionmentioning

confidence: 99%

Use of gonadotropin-releasing hormone agonist trigger during in vitro fertilization is associated with similar endocrine profiles and oocyte measures in women with and without polycystic ovary syndrome

O’Neill

Senapati

Dokras

2015

Fertility and Sterility

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Objective To compare endocrine profiles and IVF outcomes after using gonadotropin-releasing hormone agonists (GnRHa) to trigger final oocyte maturation in women with PCOS to other hyper responders. Design Retrospective cohort study Setting Academic center Patients 40 women with PCOS and 74 hyper responders without PCOS Interventions GnRHa trigger Main Outcome Measure Number of oocytes Results Serum estradiol, luteinizing hormone, and progesterone levels on the day of GnRHa trigger and the day after trigger did not differ significantly between groups. There were no significant differences in total number of oocytes or percent mature oocytes obtained between groups after controlling for age, antral follicle count and total days of stimulation. The overall rate of no retrieval of oocytes after trigger was low (2.6%). Fertilization rate, implantation rate, clinical pregnancy and live birth rates were similar in the two groups. No patients developed OHSS. Conclusions The similar post-GnRHa trigger hormonal profiles and mature oocyte yield supports the routine use of GnRHa trigger to prevent OHSS in women with PCOS.

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Section: Discussionmentioning

confidence: 99%

Use of gonadotropin-releasing hormone agonist trigger during in vitro fertilization is associated with similar endocrine profiles and oocyte measures in women with and without polycystic ovary syndrome

O’Neill

Senapati

Dokras

2015

Fertility and Sterility

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“…Several strategies have been proposed for preventing the development of OHSS [31-38] as well as some drugs, such as oral contraceptives, leuprolide acetate, metformin, dexamethasone, low-dose aspirin and dopamine agonists. These drugs have been proven to be safe for other uses and are highly effective adjuncts for ovarian stimulation in “orphan” indications [39].…”

Section: Discussionmentioning

confidence: 99%

Metformin decreases the incidence of ovarian hyperstimulation syndrome: an experimental study

Elia

Quintana²,

Carrere³

et al. 2013

J Ovarian Res

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BackgroundIn assisted reproduction cycles, gonadotropins are administered to obtain a greater number of oocytes. A majority of patients do not have an adverse response; however, approximately 3-6% develop ovarian hyperstimulation syndrome (OHSS). Metformin reduces the risk of OHSS but little is known about the possible effects and mechanisms of action involved.ObjectiveTo evaluate whether metformin attenuates some of the ovarian adverse effects caused by OHSS and to study the mechanisms involved.Material and methodsA rat OHSS model was used to investigate the effects of metformin administration. Ovarian histology and follicle counting were performed in ovarian sections stained with Masson trichrome. Vascular permeability was measured by the release of intravenously injected Evans Blue dye (EB). VEGF levels were measured by commercially immunosorbent assay kit. COX-2 protein expression was evaluated by western blot and NOS levels were analyses by immunohistochemistry.ResultsAnimals of the OHSS group showed similar physiopathology characteristics to the human syndrome: increased body weight, elevated progesterone and estradiol levels (P<0.001), increased number of corpora lutea (P<0.001), higher ovarian VEGF levels and vascular permeability (P<0.001 and P<0.01); and treatment with metformin prevented this effect (OHSS+M group; P<0.05). The vasoactive factors: COX-2 and NOS were increased in the ovaries of the OHSS group (P<0.05 and P<0.01) and metformin normalized their expression (P<0.05); suggesting that metformin has a role preventing the increased in vascular permeability caused by the syndrome.ConclusionMetformin has a beneficial effect preventing OHSS by reducing the increase in: body weight, circulating progesterone and estradiol and vascular permeability. These effects of metformin are mediated by inhibiting the increased of the vasoactive molecules: VEGF, COX-2 and partially NOS. Molecules that are increased in OHSS and are responsible for a variety of the symptoms related to OHSS.

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“…Even though pregnancy rates for frozen embryo transfer cycles in infertility patients are approximately two-thirds to those observed in fresh transfer cycles, this could be associated to an embryo selection bias due to highest quality embryos being selected during the fresh transfer. Results achieved with embryos frozen in cases of OHSS [57] as well as in cases of fertility preservation [56] appear to be similar to fresh transfer cycles. The first and largest prospective study providing pregnancy outcome data from breast cancer patients undergoing frozen embryo transfer subsequent to ovarian stimulation was recently reported by our group [56].…”

Section: Frozen Embryo Transfer Outcomes In Breast Cancer Survivorsmentioning

confidence: 59%

Embryo Cryopreservation in Breast Cancer Patients

Bedoschi

Oktay

2016

Gonadal Tissue Cryopreservation in Fertility Preservation

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Breast cancer is the second most common type of cancer expected to occur in women in 2014, accounting for 29 % of incident cases among women. Approximately 11 % of all breast cancer cases occur in women <45 years. Most of those patients are likely to undergo adjuvant systemic chemotherapy with a significant impact on ovarian reserve and future reproductive potential. Embryo cryopreservation is the most established technique for fertility preservation. This procedure is an attractive strategy for fertility preservation in reproductive age breast cancer patients with available partner or willing to use donor semen. Some special considerations should be given to ovarian stimulation for fertility preservation in breast cancer patients. The development of ovarian stimulation protocols using aromatase inhibitor combined with gonadotropin appears to be effective and safe for breast cancer patients. In this chapter, we will appraise and summarize the current state of embryo cryopreservation in breast cancer patients in order to provide a better understanding of the efficacy and safety of this fertility preservation technique. Keywords Embryo cryopreservation • Breast cancer • Fertility preservation • Ovarian stimulation • Letrozole IntroductionBreast cancer is a major public health problem in the United States and lives up to large investments in research, prevention, early diagnosis, and treatment.Breast cancer is the second most common type of cancer expected to occur in women in 2014, accounting for 29 % (232,670) of incident cases among women [1]. The relatively stable incidence rates during the past 5 years for which there are data reflect improvements in cancer control and screening methods. At the same time, the detection of cancer at an early stage and the development of the treatment

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Embryo freezing for preventing ovarian hyperstimulation syndrome

Cited by 33 publications

References 36 publications

Use of gonadotropin-releasing hormone agonist trigger during in vitro fertilization is associated with similar endocrine profiles and oocyte measures in women with and without polycystic ovary syndrome

Use of gonadotropin-releasing hormone agonist trigger during in vitro fertilization is associated with similar endocrine profiles and oocyte measures in women with and without polycystic ovary syndrome

Metformin decreases the incidence of ovarian hyperstimulation syndrome: an experimental study

Embryo Cryopreservation in Breast Cancer Patients

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