Severe ovarian hyperstimulation syndrome modifies early maternal serum beta-human chorionic gonadotropin kinetics, but obstetrical and neonatal outcomes are not impacted

Abstract

Objective: To study the impact of severe ovarian hyperstimulation syndrome (OHSS) on beta-hCG kinetics and obstetrical and neonatal outcomes.

Design: Retrospective single-center case-control study.

Setting: University tertiary referral center.

Patient(s): A total of 77 patients who presented a clinical pregnancy after IVF and had been hospitalized for severe OHSS were included in this study and compared with 231 controls presenting an IVF-induced clinical pregnancy without OHSS and matched for the year of pregnancy and the number of gestational sacs.

Intervention(s): None.

Main outcomes measure(s): The outcome of pregnancy (miscarriage, medical abortion, or delivery), beta-hCG values, obstetrical, and neonatal outcomes.

Result(s): After multivariate analysis adjusted for parity, tobacco smoking, presence of polycystic ovary syndrome, age, and body mass index, outcomes of pregnancies were not altered by OHSS. However, there was a trend toward a lower early miscarriage rate in the OHSS group (7.8%) than in the control group (16%). Maternal serum beta-hCG values at different time points of the pregnancy and fold changes of beta-hCG values were lower in OHSS than in controls (268 ± 160 vs. 389 ± 215 IU/L at day 16; and 4.8 ± 1.5 vs. 5.4 ± 1.4 fold change between day 16 and day 20). Beta-hCG also correlated negatively with the number of oocytes retrieved. Incidence of gestational diabetes, gestational hypertension, intrauterine growth restriction, premature birth, and low birth weight did not differ between groups.

Conclusion(s): Although early maternal serum beta-hCG kinetics were modified in women after severe OHSS, the outcomes of these pregnancies remained comparable to those of IVF pregnancies without OHSS. According to these data, pregnancies after severe OHSS do not require particular care compared with IVF pregnancies, but differences in beta-hCG levels and kinetics should be taken into account when interpreting these results.

Keywords: Assisted reproductive technologies; beta-hCG; in vitro fertilization; obstetrical outcomes; ovarian hyperstimulation syndrome.