Utility of Estradiol as a Predictive Marker of Ovarian Hyper Stimulation Syndrome

Introduction: Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication derived from assisted reproduction treatments. The current trend is to achieve a reduction in its incidence by early detection of those women who present an increased risk and applying effective preventive measures in such cases to prevent their development. The objective of this study is to demonstrate the usefulness of estradiol levels in follicular fluid as a predictive factor of OHSS.

Material and methods: A retrospective study of the cycles of ovarian stimulation performed at the Assisted Reproduction Unit of our hospital for 6 months, with a sample size of 110 patients. Measurement of basal estradiol and follicular fluid levels in these patients in relation to the development of this complication. Statistical analysis consisted of a comparison of hypotheses to compare means in the two study groups, followed by ROC curves to know the predictive capacity of both variables. All this was done using SPSS version 15.0 statistical package.

Results: Follicular estradiol concentrations were related to the development of OHSS, significantly (p<0.01). In addition, significant differences were observed in follicular estradiol concentrations in patients who developed OHSS and those who did not suffer from this complication.

Discussion: It is demonstrated the usefulness of the measurement of oestradiol in follicular fluid from ovarian puncture as a marker of risk of development of OHSS, providing an objective data to all known predisposing factors and thus avoiding the need for blood extraction on the day of the administration of hCG as an inducer of ovulation.


Mercedes Calero Ruiz, Javier María Gutiérrez Romero, Iratxe López Pelayo and Ángeles Bailén García

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