Application of plasma D-dimer detection in ovarian hyperstimulation syndrome

Background: This study investigated the changes of plasma D-dimer level and the role of its test in the pathogenesis of ovarian hyperstimulation syndrome (OHSS). Overall, 140 patients were divided into four groups based on OHSS status: normal, mild, moderate, and severe. All patients were hospitalized because of embryo transfer or OHSS. We retrospectively analyzed their clinical data, hormone levels, ovulation induction agents, and plasma D-dimer levels during the occurrence of OHSS and improved stages. Results: : Plasma D-dimer levels were significantly higher in the four groups with early onset of symptoms (P<0.05; reference value, 0–0.5 µg/mL) than in the normal group. With increasing symptoms of OHSS, D-dimer levels gradually increased in all four groups. There was a significant positive correlation between symptoms and D-dimer levels (γ=0.575; P<0.05), and the 95% confidence intervals of the three OHSS groups were 0.71–1.41 µg/mL (mild group), 1.65–2.26 µg/mL (moderate group), and 2.24–3.62 µg/mL (severe group). The cross-interval between the different groups of OHSS symptoms was minimal. When OHSS symptoms improved or healed based on the patient’s clinical manifestations and laboratory parameters, the D-dimer levels of patients with moderate and severe symptoms remained significantly higher than the normal range (P<0.05). The D-dimer levels in the improved stage in moderate and severe groups were significantly higher than those in the early stage (P<0.05). Conclusions: : According to elevated D-dimer levels, we can more accurately predict the severity of OHSS in the early stage. Additionally, with further increases in D-dimer levels along with symptoms, we can more precisely determine the prognosis of patients.