Haematocrit, leukocyte and platelet counts and the severity of the ovarian hyperstimulation syndrome

Abstract

Previous studies have shown that severe ovarian hyperstimulation syndrome (OHSS) is secondary to circulatory dysfunction due to the simultaneous occurrence of increased vascular permeability and marked arteriolar vasodilation which lead to an intense homeostatic stimulation of the renin-aldosterone and sympathetic nervous systems and antidiuretic hormone (ADH). In the present report, we have investigated the correlation between changes in haematocrit concentration, and white blood cell (WBC) and platelet counts and the severity of OHSS, as assessed by these markers of effective intra-arterial blood volume, in a series of 50 patients. In comparison with recovery values (4-5 weeks after hospital discharge), OHSS patients showed arterial hypotension, tachycardia, oliguria, very high plasma concentrations of renin, aldosterone, norepinephrine and ADH, and increased mean haematocrit values and WBC and platelet counts. The haematocrit concentration values were directly related to the plasma concentrations of vasoactive substances (plasma renin activity, aldosterone, norepinephrine and ADH) during OHSS (P < 0.001). In contrast, no correlation was evident between WBC or platelet counts and neurohormonal measurements during the syndrome. It is concluded that haematocrit, but not WBC or platelet counts, can act as a biological marker of the severity of OHSS as indicated by plasma measurement of volume-dependent endogenous vasoactive substances.

Ultrasound and hematological changes during early luteal phase in women at high risk for developing ovarian hyperstimulation syndrome

“…The increase in Ht of 6.27% (16.51% relative increase) observed in the current study between day 0 and day 5, in patients who developed severe early OHSS, is in agreement with previous arbitrarily proposed values of 10% 35 and 6-10% 12 Ht increase over the baseline, but not, however, with a 30% increase, also proposed arbitrarily for diagnosis of severe OHSS by Navot et al 4 . Our current data suggest that cHt is directly associated with the quantity of ascetic fluid accumulation.…”

Early ovarian hyperstimulation syndrome is completely prevented by gonadotropin releasing-hormone agonist triggering in high-risk oocyte donor cycles: a prospective, luteal-phase follow-up study

“…Hemoconcentration is a particularly sensitive marker of the degree of OHSS severity (15). It is remarkable that mean luteal hematocrit values were significantly different (2 points lower) from basal values recorded in the same patient before ovarian stimulation, thus excluding any OHSS-related hemoconcentration.…”

Ovarian hyper stimulation syndrome: a case report

“…This ovarian reninangiotensin system is thought to be involved in the neovascularization which is so central a feature of the conversion of the avascular pre-ovulatory follicle into the richly vascularized corpus luteum. 8 Vascular endothelial growth factor (VEGF) increases capillary permeability and is expressed in steroid genic and steroid-responsive cells, such as those involved in repair of endometrial vessels and implantation. 9 Recent evidence argues for a critical role of several other mediators including various cytokines such as interleukin IL-1, IL-6, IL-8 and tumor necrosis factor.…”