The questionable use of albumin for the prevention of ovarian hyperstimulation syndrome in an IVF programme: a randomized placebo-controlled trial

BACKGROUND: The role of intravenous (IV) albumin administration in the prev ention of ovarian hyperstimulation syndrome (OHSS) and in the improvement o f IVF conception outcomes was evaluated in a prospective, randomized, place bo-controlled double blind study. METHODS: Ninety-eight women were enrolled in the study and were consecutively assigned to either a treatment group o r a control group. Eleven patients were lost to follow-up after assignment. Of the remaining 87 women, 46 received albumin on the day of oocyte retrie val, and 41 received 0.9% sodium chloride solution as a placebo control. Ou tcome measures included OHSS incidence rates and pregnancy rates in the two trial groups. RESULTS: Four of the 46 patients in the study group develope d severe OHSS and six developed moderate OHSS. In the control group, one of the 41 developed severe OHSS and five developed moderate OHSS. The differe nce in OHSS incidence rates between the two groups was not statistically si gnificant [relative risk (RR) = 1.49, 95% CI = 0.59-3.73]. Fourteen patient s (30%) in the intervention group conceived, compared with 16 patients (39% ) in the control group. The difference in conception rates between the two groups was not statistically significant (RR = 0.78, 95% CI = 0.44-1.39). C ONCLUSIONS: Albumin appears to have no positive effect on OHSS or conceptio n rates, while its use carries the risk of undesirable side effects, includ ing exacerbation of ascites in OHSS, nausea, vomiting, febrile reaction, al lergic reaction, anaphylactic shock and risk of virus and prion transmissio n. We suggest that this form of treatment should not be included in the pre vention of OHSS.