Serum estradiol level and oocyte number in predicting severe ovarian hyperstimulation syndrome

Chin Der Chen, Ming Yih Wu, Kuang Han Chan, Shee Uan Chen, Hong Nerng Ho, Yu Shih Yang

研究成果: 雜誌貢獻文章

33 引文 (Scopus)

摘要

Ovarian hyperstimulation syndrome (OHSS) is a relatively common and potentially life-threatening complication of ovarian stimulation, the pathogenesis of which remains unclear. To clarify the predictive values of serum estradiol levels and oocyte number in severe OHSS, and to investigate the impact of high serum estradiol levels on pregnancy outcome, we retrospectively analyzed clinical data from 431 cycles of ovarian stimulation for assisted reproduction performed from 1993 through 1995. Receiver operating characteristic plots were used to estimate the predictive power of the measured variables. The overall frequency of severe OHSS was 5.5%. Using a serum estradiol level of 3,600 pg/mL as the minimum cut-off value, the sensitivity was 58%, with a specificity of 92%, a positive predictive value of 29%, and a negative predictive value of 97%. The predictive power was similar when a cut-off point of 20 oocytes retrieved was used. The two criteria together gave a sensitivity of 33%, a specificity of 92%, a positive predictive value of 40%, and a negative predictive value of 98%. One of seven oocyte donors developed severe OHSS. The pregnancy rate was higher in patients with severe OHSS than in patients who did not develop this syndrome (73.9% vs 32.5%) but the pregnancy outcomes were not significantly different. We conclude that elevated estradiol concentrations and oocyte number appear to be helpful in predicting severe OHSS, but neither parameter by itself is predictive. This syndrome is rare in the absence of luteal hCG support, either exogenous or pregnancy-derived; when it occurs, there are usually extremely high preovulatory estradiol concentrations and numerous oocytes retrieved. High serum estradiol levels are unlikely to have adverse effects on pregnancy outcome in patients with severe OHSS.
原文英語
頁(從 - 到)829-834
頁數6
期刊Journal of the Formosan Medical Association
96
發行號10
出版狀態已發佈 - 十月 1 1997
對外發佈Yes

指紋

Ovarian Hyperstimulation Syndrome
Ovulation Induction
Chorionic Gonadotropin
Fertilization in Vitro
ROC Curve
Oocytes
Estradiol
Pregnancy
Serum
Pregnancy Outcome
Corpus Luteum
Pregnancy Rate
Reproduction
Tissue Donors

ASJC Scopus subject areas

  • Medicine(all)

引用此文

Serum estradiol level and oocyte number in predicting severe ovarian hyperstimulation syndrome. / Chen, Chin Der; Wu, Ming Yih; Chan, Kuang Han; Chen, Shee Uan; Ho, Hong Nerng; Yang, Yu Shih.

於: Journal of the Formosan Medical Association, 卷 96, 編號 10, 01.10.1997, p. 829-834.

研究成果: 雜誌貢獻文章

Chen, Chin Der ; Wu, Ming Yih ; Chan, Kuang Han ; Chen, Shee Uan ; Ho, Hong Nerng ; Yang, Yu Shih. / Serum estradiol level and oocyte number in predicting severe ovarian hyperstimulation syndrome. 於: Journal of the Formosan Medical Association. 1997 ; 卷 96, 編號 10. 頁 829-834.
@article{0893f50254e347a99087ecb278a745e8,
title = "Serum estradiol level and oocyte number in predicting severe ovarian hyperstimulation syndrome",
abstract = "Ovarian hyperstimulation syndrome (OHSS) is a relatively common and potentially life-threatening complication of ovarian stimulation, the pathogenesis of which remains unclear. To clarify the predictive values of serum estradiol levels and oocyte number in severe OHSS, and to investigate the impact of high serum estradiol levels on pregnancy outcome, we retrospectively analyzed clinical data from 431 cycles of ovarian stimulation for assisted reproduction performed from 1993 through 1995. Receiver operating characteristic plots were used to estimate the predictive power of the measured variables. The overall frequency of severe OHSS was 5.5{\%}. Using a serum estradiol level of 3,600 pg/mL as the minimum cut-off value, the sensitivity was 58{\%}, with a specificity of 92{\%}, a positive predictive value of 29{\%}, and a negative predictive value of 97{\%}. The predictive power was similar when a cut-off point of 20 oocytes retrieved was used. The two criteria together gave a sensitivity of 33{\%}, a specificity of 92{\%}, a positive predictive value of 40{\%}, and a negative predictive value of 98{\%}. One of seven oocyte donors developed severe OHSS. The pregnancy rate was higher in patients with severe OHSS than in patients who did not develop this syndrome (73.9{\%} vs 32.5{\%}) but the pregnancy outcomes were not significantly different. We conclude that elevated estradiol concentrations and oocyte number appear to be helpful in predicting severe OHSS, but neither parameter by itself is predictive. This syndrome is rare in the absence of luteal hCG support, either exogenous or pregnancy-derived; when it occurs, there are usually extremely high preovulatory estradiol concentrations and numerous oocytes retrieved. High serum estradiol levels are unlikely to have adverse effects on pregnancy outcome in patients with severe OHSS.",
keywords = "In vitro fertilization, Oocyte number, Ovarian stimulation, Receiver operating characteristic",
author = "Chen, {Chin Der} and Wu, {Ming Yih} and Chan, {Kuang Han} and Chen, {Shee Uan} and Ho, {Hong Nerng} and Yang, {Yu Shih}",
year = "1997",
month = "10",
day = "1",
language = "English",
volume = "96",
pages = "829--834",
journal = "Journal of the Formosan Medical Association",
issn = "0929-6646",
publisher = "Elsevier Science Publishers B.V.",
number = "10",

}

TY - JOUR

T1 - Serum estradiol level and oocyte number in predicting severe ovarian hyperstimulation syndrome

AU - Chen, Chin Der

AU - Wu, Ming Yih

AU - Chan, Kuang Han

AU - Chen, Shee Uan

AU - Ho, Hong Nerng

AU - Yang, Yu Shih

PY - 1997/10/1

Y1 - 1997/10/1

N2 - Ovarian hyperstimulation syndrome (OHSS) is a relatively common and potentially life-threatening complication of ovarian stimulation, the pathogenesis of which remains unclear. To clarify the predictive values of serum estradiol levels and oocyte number in severe OHSS, and to investigate the impact of high serum estradiol levels on pregnancy outcome, we retrospectively analyzed clinical data from 431 cycles of ovarian stimulation for assisted reproduction performed from 1993 through 1995. Receiver operating characteristic plots were used to estimate the predictive power of the measured variables. The overall frequency of severe OHSS was 5.5%. Using a serum estradiol level of 3,600 pg/mL as the minimum cut-off value, the sensitivity was 58%, with a specificity of 92%, a positive predictive value of 29%, and a negative predictive value of 97%. The predictive power was similar when a cut-off point of 20 oocytes retrieved was used. The two criteria together gave a sensitivity of 33%, a specificity of 92%, a positive predictive value of 40%, and a negative predictive value of 98%. One of seven oocyte donors developed severe OHSS. The pregnancy rate was higher in patients with severe OHSS than in patients who did not develop this syndrome (73.9% vs 32.5%) but the pregnancy outcomes were not significantly different. We conclude that elevated estradiol concentrations and oocyte number appear to be helpful in predicting severe OHSS, but neither parameter by itself is predictive. This syndrome is rare in the absence of luteal hCG support, either exogenous or pregnancy-derived; when it occurs, there are usually extremely high preovulatory estradiol concentrations and numerous oocytes retrieved. High serum estradiol levels are unlikely to have adverse effects on pregnancy outcome in patients with severe OHSS.

AB - Ovarian hyperstimulation syndrome (OHSS) is a relatively common and potentially life-threatening complication of ovarian stimulation, the pathogenesis of which remains unclear. To clarify the predictive values of serum estradiol levels and oocyte number in severe OHSS, and to investigate the impact of high serum estradiol levels on pregnancy outcome, we retrospectively analyzed clinical data from 431 cycles of ovarian stimulation for assisted reproduction performed from 1993 through 1995. Receiver operating characteristic plots were used to estimate the predictive power of the measured variables. The overall frequency of severe OHSS was 5.5%. Using a serum estradiol level of 3,600 pg/mL as the minimum cut-off value, the sensitivity was 58%, with a specificity of 92%, a positive predictive value of 29%, and a negative predictive value of 97%. The predictive power was similar when a cut-off point of 20 oocytes retrieved was used. The two criteria together gave a sensitivity of 33%, a specificity of 92%, a positive predictive value of 40%, and a negative predictive value of 98%. One of seven oocyte donors developed severe OHSS. The pregnancy rate was higher in patients with severe OHSS than in patients who did not develop this syndrome (73.9% vs 32.5%) but the pregnancy outcomes were not significantly different. We conclude that elevated estradiol concentrations and oocyte number appear to be helpful in predicting severe OHSS, but neither parameter by itself is predictive. This syndrome is rare in the absence of luteal hCG support, either exogenous or pregnancy-derived; when it occurs, there are usually extremely high preovulatory estradiol concentrations and numerous oocytes retrieved. High serum estradiol levels are unlikely to have adverse effects on pregnancy outcome in patients with severe OHSS.

KW - In vitro fertilization

KW - Oocyte number

KW - Ovarian stimulation

KW - Receiver operating characteristic

UR - http://www.scopus.com/inward/record.url?scp=0030782341&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030782341&partnerID=8YFLogxK

M3 - Article

C2 - 9343984

AN - SCOPUS:0030782341

VL - 96

SP - 829

EP - 834

JO - Journal of the Formosan Medical Association

JF - Journal of the Formosan Medical Association

SN - 0929-6646

IS - 10

ER -