COMPARISON OF INTRAVENOUS ALBUMIN AND TRANSFER OF FRESH EMBRYOS WITH CRYOPRESERVATION OF ALL EMBRYOS FOR SUBSEQUENT TRANSFER IN PREVENTION OF OVARIAN HYPERSTIMULATION SYNDROME

Objective: To compare the efficacy of administering IV albumin to prev ent severe ovarian hyperstimulation syndrome (OHSS) in patients underg oing ovarian stimulation for IVF with a standard policy of cryopreserv ing all embryos and to assess the impact of the two methods of treatme nt on pregnancy rates (PRs). Design: Prospective randomized study. Set ting: A tertiary referral center for assisted conception. Patients: Tw enty-six patients undergoing IVF treatment cycles who were considered to be at high risk of developing severe OHSS on the basis of their ser um E(2) concentrations on the day of hCG administration and the number of oocytes collected. Intervention: In group 1 (n = 13) all the gener ated embryos were cryopreserved to be transferred subsequently in horm onally manipulated cycles. In group 2 (n = 13) patients received TV in fusions of albumin on the day of oocyte retrieval and 5 days later. Pa tients in group 2 had transfers of fresh embryos. Main Outcome Measure s: The total dosage of hMG used, total number of follicles developed, number of follicles > 14 mm in diameter, serum E(2) concentrations and endometrial thickness on day of hCG administration, number of oocytes retrieved, number and quality of embryos generated, PRs per cycle com menced, and onset and degree of any OHSS developed. Results: There wer e no significant differences in the above parameters between the two g roups, except for PRs that were significantly higher in patients who h ad all embryos cryopreserved (38.46% versus 0%). Conclusion: The polic y of cryopreserving all generated embryos appears as effective as the administration of TV albumin in preventing OHSS in high-risk patients and produces significantly higher PRs.