Application of gonadotropin-releasing hormone antagonist in the prevention and treatment of early ovarian hyperstimulation syndrome

Objective To investigate the effect of gonadotropin-releasing hormone antagonist (GnRH-A) in the prevention and treatment of early moderate and severe ovarian hyperstimulation syndrome (OHSS) during in vitro fertilization-embryo transfer (IVF-ET) cycles. Methods A retrospective cohort analysis was performed at our center. A total of 138 infertile women undergoing reproductive technique with high risk of OHSS were enrolled in this clinical trial and were divided into two groups. The treatment was given from the day of oocytes retrivded and fresh transplantation was cancelled in the two groups. Control group with 76 patients [serum estradiol (E2) level≥4 000 ng/L and <6 000 ng/L and/or the number of oocytes retrieved ≥15 on the day of hCG injection) was given routine preventative treatment. GnRH-A group with 62 patients (serum E2 level≥6 000 ng/L on the day of hCG injection) was given the routine preventative treatment and 0.25 mg cetrorelix at a time. The incidence of moderate and severe OHSS was surveyed and the clinical data of patients in the two groups were analyzed. Results There were no severe OHSS in the two groups. The incidence of moderate OHSS was lower in GnRH-A group than control group (P=0.243). The serum E2 level in the GnRH-A group dropped faster when using GnRH-A (P=0.00). Conclusion GnRH-A can reduce the incidence of moderate and severe OHSS. GnRH-A used at a time on the day of oocytes retrived to the patients with high risk of OHSS could significant reduce the incidence of moderate and severe OHSS, reduce the symptoms and economic burden of patients, it can be used as an effective measure to prevent and treat early moderate and severe OHSS. Key words: Gonadotropin-releasing hormone antagonist (GnRH-A); In vitro fertilization-embryo transfer (IVF-ET); Ovarian hyperstimulation syndrome (OHSS)