STATUS OF THE COAGULATION AND FIBRINOLYTIC SYSTEMS IN OVARIAN HYPERSTIMULATION SYNDROME

Objective: To elucidate characteristic changes of plasma hemostatic ma rkers in ovarian hyperstimulation syndrome (OHSS) cycles. Design: Pros pective study. Setting: The IVF-ET program of the Department of Obstet rics and Gynecology, The University of Akita, School of Medicine. Pati ents: Forty cycles of 40 IVF patients, including 12 cycles in which a severe form of OHSS occurred. Interventions: Blood samples were taken during IVF treatment to determine the levels of blood markers that ref lect activation of the coagulation and fibrinolytic systems. Main Outc ome Measures: Thrombin-antithrombin III complexes, plasmin-alpha(2) an tiplasmin complexes, and other hemostatic markers related to the coagu lation and fibrinolytic system activation. Results: In the OHSS cycles , the levels of thrombin-antithrombin III and plasmin-alpha(2) antipla smin complexes in the plasma began to rise within a few days after hCG administration and demonstrated significantly higher levels during th e midluteal phase. In OHSS cycles with pregnancy, elevation of these m arkers continued for greater than or equal to 3 weeks after the onset of disease. There were some characteristic changes in OHSS cycles in o ther hemostatic markers, such as a decrease in the levels of antithrom bin III and prekallikrein and shortened activated partial thromboplast in time. Conclusion: These data demonstrate the status of the coagulat ion and fibrinolytic systems in OHSS cycles and provide insight into t he mechanism of activation in the hemostatic system.