EARLY TIMED FOLLICULAR ASPIRATION PREVENTS SEVERE OVARIAN HYPERSTIMULATION SYNDROME

Purpose: Early timed follicular aspiration (ETFA) of one ovary 10-12 h r after administration of chorionic gonadotropin (hCG) is an attempt t o prevent severe ovarian hyperstimulation syndrome (OHSS). After the i ntroduction of early timed follicular aspiration ETFA of one ovary in IVF/ET cycles at high risk for severe OHSS, no cases of severe OHSS we re registered in the Ljubljana IVF/ET program. In the period before pr eventive ETFA (1984-1992) there were 16 cases of severe OHSS of 4798 I VF/ET cycles followed by 577 clinical pregnancies. After the introduct ion of ETFA (1992-1993) there were no cases of severe OHSS of 2289 IVF /ET cycles followed by 364 clinical pregnancies. Methods: We attempted to evaluate the significance of this observation by comparing two gro ups of female infertility IVF/ET cycles at high risk for severe OHSS. The occurrence of severe OHSS and clinical parameters ill the two grou ps of IVF/ET cycles at high risk for severe OHSS were compared. Result s: In the group of 106 IVF/ET female infertility cycles at high risk o f severe OHSS with preventive ETFA, there were no cases of severe OHSS . In the control group of 92 IVF/ET female infertility cycles at high risk for severe OHSS with normally rimed follicular aspiration (NTFA) of both ovaries, severe OHSS occurred in 16 cases. The difference in t he occurrence of severe OHSS between the two groups is highly signific ant (P <0.005), both in hMGlhCG- and in GnRHa/hMG/hCG-induced IVF/ET c ycles. No difference in live birth rare (16 vs. 16%) between the two g roups was noted. Conclusions: Considering these results we conclude th at ETFA is another successful option to decrease the incidence of seve re OHSS in assisted reproduction. The preventive effect of follicular aspiration seems to depend on its timing.