Intravenous albumin versus hydroxyethyl starch for the prevention of ovarian hyperstimulation in an in-vitro fertilization programme: a prospective randomized placebo controlled study

A prospective randomized placebo controlled clinical trial was carried out on 250 patients (cycles) considered at risk of developing OHSS in an IVF pr ogramme. Criteria for inclusion were: estradiol value of more than 3000 pg/ ml or the presence of more than 20 follicles on the day of hCG administrati on. Patients were randomized by using a random table to receive either 20% human albumin 50 mi (n: 82); 6% hydroxyethyl starch (200/0.5) 500 mi (n: 85 ) or a placebo of 500 mi 0.9% NaCl solution (n: 83) over 30 min during oocy te collection. Groups were similar with respect to patients' age, estradiol levels on hCG day, body mass index, number of oocytes retrieved, number of embryos transferred and pregnancies (P > 0.05). There was no severe OHSS i n patients who received albumin and HES while four patients who received pl acebo developed severe OHSS. On the other hand moderate OHSS was encountere d in four patients in the albumin group; five patients receiving HES; and 1 2 patients receiving placebo. There was a statistically significant differe nce in the incidence of moderate, severe and overall OHSS among groups (P v alues of <0.05, <0.05, and <0.01, respectively). Both HES and albumin signi ficantly reduced the incidence of moderate, severe and overall incidence of OHSS. It is concluded that hydroxyethyl starch is a cheaper and safer alte rnative to Human Albumin in OHSS prevention. (C) 2001 Elsevier Science Irel and Ltd. All rights reserved.