Management and obstetric outcome of ovarian hyperstimulation syndrome

OBJECTIVE: To describe the management and obstetric outcome, in terms of take home baby rate, of Ovarian Hyperstimulation Syndrome (OHSS). STUDY DESIGN: Case series. PLACE AND DURATION OF STUDY: Baqai University Hospital, Nazimabad and Baqai Institute of Reproduction and Developmental Sciences, from January 1998 to December 2002. PATIENTS AND METHODS: All patients undergoing in vitro fertilization and intracytoplasmic sperm injection from 5th January 1998 till 12th December 2002 were selected for the study. The infertile couple were interviewed, after informed consent, examined and investigated. Ovulation induction agents were prescribed to the female, if all the investigations were normal. In vitro fertilization was reserved for blocked fallopian tubes, endometriosis and abnormal semen parameters. Intracytoplasmic sperm injection was indicated for cases with few normal sperms. All the patients, who had developed mild ovarian hyperstimulation syndrome were excluded from the study. The patients who had developed moderate and severe ovarian hyperstimulation syndrome were included in the study. RESULTS: Out of 30 patients who developed OHSS, 23 had moderate OHSS, 7 patients had developed severe OHSS. Polycystic ovaries were present in 21 cases. Clinical pregnancy rate in the study was 40% and the take-home baby rate was 21.7%. Patients with polycystic ovarian disease were identified as the main reason for subfertility and were identified as the main reason for adverse foetal outcome. CONCLUSION: A remarkable pregnancy rate was achieved, but the take-home baby rate was comparatively low. But even then, the results were comparable in terms of take-home baby rate to the results reported in international literature.