Principles of Oocyte and Embryo Donation by Mark V. Sauer

Author:Mark V. Sauer
Language: eng
Format: epub
Publisher: Springer London, London

Ovarian Hyperstimulation Syndrome

Oocyte donors are only exposed to early-onset OHSS due to the absence of a subsequent pregnancy. This risk however should not be underestimated because donors are typically young women selected to have good ovarian reserve, and they frequently yield a large number of oocytes. It was estimated that donors who develop >20 follicles are exposed to a 15 % OHSS risk with the possibility of subsequent hospital admission [20]. The overall incidence of OHSS in the context of oocyte donation was addressed only by few studies. Sauer et al. reported a 1.5 % incidence of severe OHSS in a series of 400 long agonist donor cycles [21]. Despite high peak estradiol levels, no severe complications occurred, and hospitalization was not required. This relatively favorable course is due to the absence of a subsequent pregnancy, since unlike IVF patients, egg donors are exposed only to hCG-induced early OHSS. A more recent large randomized clinical trial which evaluated three different gonadotropin regimens (with a long agonist stimulation protocol and hCG trigger) including >1,000 oocyte donors reported a 5–7 % mild/moderate OHSS rate despite liberal cycle cancellation policy [22]. These studies highlight the fact that if effective preventive OHSS measures are not implemented, moderate/severe OHSS is expected to occur in oocyte donors in varying degrees depending on the type of stimulation protocol and triggering agent used.

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