The dark side of random-start ovarian stimulation: ovarian hyperstimulation syndrome due to inadvertent pregnancy

IF 3.7 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Reproductive biomedicine online Pub Date : 2024-05-18 DOI:10.1016/j.rbmo.2024.104121

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引用次数: 0

Abstract

Research question

Can inadvertent pregnancies go unnoticed when initiating random-start ovarian stimulation (RSOS) despite monitoring?

Design

Case series at a university-based tertiary care fertility clinic.

Results

Between June 2022 and December 2023, two cases of undetected early pregnancy at the onset of RSOS were identified, both leading to severe ovarian hyperstimulation syndrome (OHSS) with hospitalization.

Conclusion

RSOS protocols add flexibility in fertility clinics when there is no intention of a fresh embryo transfer, but may be associated with insidious risk of OHSS. The authors advocate for comprehensive consultation and serial monitoring of human chorionic gonadotrophin during ovarian stimulation, while cautioning against over-reliance on baseline hormone concentrations when initiating RSOS. If the benefits of RSOS seem limited, healthcare providers should consider delaying ovarian stimulation to avert health, but also medicolegal and financial, complications.

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随机启动卵巢刺激的阴暗面：意外妊娠导致的 OHSS

研究问题：在启动随机启动卵巢刺激（RSOS）时，尽管进行了监测，但是否会发生意外妊娠而未被发现？结果在 2022 年 6 月至 2023 年 12 月期间，发现了两例在 RSOS 开始时未检测到的早孕病例，均导致严重的卵巢过度刺激综合征（OHSS）并住院治疗。作者主张在卵巢刺激过程中进行全面咨询并对人绒毛膜促性腺激素进行连续监测，同时提醒在启动 RSOS 时不要过度依赖激素基线浓度。如果 RSOS 的益处似乎有限，医疗服务提供者应考虑推迟卵巢刺激，以避免健康、医疗法律和财务方面的并发症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Reproductive biomedicine online 医学-妇产科学

CiteScore

7.20

自引率

7.50%

发文量

391

审稿时长

50 days

期刊介绍： Reproductive BioMedicine Online covers the formation, growth and differentiation of the human embryo. It is intended to bring to public attention new research on biological and clinical research on human reproduction and the human embryo including relevant studies on animals. It is published by a group of scientists and clinicians working in these fields of study. Its audience comprises researchers, clinicians, practitioners, academics and patients. Context: The period of human embryonic growth covered is between the formation of the primordial germ cells in the fetus until mid-pregnancy. High quality research on lower animals is included if it helps to clarify the human situation. Studies progressing to birth and later are published if they have a direct bearing on events in the earlier stages of pregnancy.