OC09.03: A carotid ultrasound study of the effectiveness of hormone therapy in preventing arteriosclerosis in women with premature ovarian failure and in menopausal women

Abstract

Objectives: Ovarian hyper stimulation syndrome (OHSS) is the most severe iatrogenic complication of ovulation induction. It has been suggested that OHSS might carry an increased risk of obstetric complication once the pregnancy is established. The aim of this meta-analysis was to explore the association between OHSS and adverse obstetric outcome. Methods: This review was performed according to a protocol designed to PRISM guidelines. Event rate was calculated for all the studies included in the analysis while risk ratio and risk difference were calculated compared to pregnancies conceived with assisted reproduction techniques (ART) but not affected by OHSS. Quality assessment of studies was also performed. Between-study heterogeneity was explored using the I2 statistic, and fixed or random effect models were used accordingly. The outcomes observed were pre-eclampsia (PE), gestational diabetes mellitus (GDM), small for gestational age (SGA), preterm delivery (PTD) and thromboembolic events. Results: A total of 1738 articles were identified during the search and a total of 9 studies (2859 patients) were included in the systematic review and meta-analysis. The rates of PE, GDM and thromboembolic events were 9.6% (95% CI 6.9-13.3), 6.2% (95% CI 3.4-11.1) and 3.0% (95% CI 0.9-9.9), respectively, with no significant difference between OHSS cases and controls. The rates of SGA and PTD were 38.9% (95% CI 28.6-50.4) and 30.0% (95% CI 21.7-39.8). Both these complications were seen significantly more often in OHSS cases compared to controls: RR: 1.59 (95% CI 1.15-2.22) and RR: 1.25 (95% CI 1.17-1.34), respectively. Conclusions: OHSS is associated with an increased risk of both SGA and PTD compared to ART pregnancies uncomplicated by OHSS. OC09.02What is the significance of an intertwin size discrepancy in the first trimester of IVF pregnancies? We hypothesized that twin pregnancies which demonstrate larger size discrepancies would be associated with a number of outcomes: 'vanishing twin', increased risk of prematurity and preterm delivery. Methods: Prospective study of women with live first trimester DCDA twin pregnancies following IVF All women underwent TVUS when the CRL of both twins was measured. The intertwin size discrepancy was determined by subtracting the smaller twin from the larger twin and dividing by the larger twin. Pregnancy outcomes: final order of pregnancy, gestational age and weight at delivery were noted. The t-test and univariate analysis were used. * This presentation is eligible for the Young Investigator award (to be presented in the closing session).Results: 242 DCDA twin pregnancies were included. First trimester measurements were made between 6+0 and 12+6 wks. 184 pregnancies continued as twins (76%), 39 reduced to a singleton pregnancy (16%), 19 pregnancies miscarried (7.9%). The mean GA of delivery was 34+1 (±5.23d), with 100 pregnancies (41.3%) delivering at term (37-41 wks); 123 (51.4%) delivering preterm (24-37 wks) and 19 (7.9%) miscarriages (<24wks). There were 6 neonatal deaths.There was ...