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Severe ovarian hyperstimulation syndrome associated with long-acting GnRH agonist in oncofertility patients

  • Fertility Preservation
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

A Letter to Editor to this article was published on 25 August 2021

Abstract

Purpose

To report three cases of severe ovarian hyperstimulation syndrome (OHSS) among oncofertility patients receiving a long-acting GnRH agonist for ovarian suppression after controlled ovarian hyperstimulation (COH) with a GnRH antagonist protocol

Methods

Chart abstraction was completed for three patients at a single academic medical center. Patients included were undergoing fertility preservation prior to gonadotoxic chemotherapy. All patients underwent COH with GnRH antagonist protocol and embryo cryopreservation immediately followed by ovarian suppression with long-acting GnRH agonist. Main outcome measure was development of OHSS.

Results

Despite using GnRH agonist trigger and freezing all embryos, patients developed ascites, intermittent hyponatremia and hemoconcentration consistent with severe early-onset OHSS after receiving long-acting GnRH agonist immediately following oocyte retrieval for ovarian preservation.

Conclusions

Risk of severe OHSS may be increased when a long-acting GnRH agonist is used for ovarian suppression immediately following oocyte retrieval. A delay in initiating long-acting GnRH agonist after oocyte retrieval in patients at high risk for developing OHSS should be considered.

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Funding

This study is partially supported by NIH K08CA222835 and P30CA015704 (to B.Y.).

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Washington, 1959 NE Pacific St, Seattle, WA, 98195, USA

    Jacob Christ, Christopher N. Herndon & Bo Yu

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  1. Jacob Christ
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  2. Christopher N. Herndon
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  3. Bo Yu
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Correspondence to Bo Yu.

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The authors declare that they have no conflict of interest.

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All data was obtained from chart review and reported without any patient identifiers. IRB exemption from our institution was obtained for this study.

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Christ, J., Herndon, C.N. & Yu, B. Severe ovarian hyperstimulation syndrome associated with long-acting GnRH agonist in oncofertility patients. J Assist Reprod Genet 38, 751–756 (2021). https://doi.org/10.1007/s10815-020-02051-7

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  • DOI: https://doi.org/10.1007/s10815-020-02051-7

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