Ovarian hyperstimulation syndrome

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A young couple tries to concieve for a long time. As the effort is unsuccesful, they arrive to The Centre for Assisted Reproduction. After some examinations the doctor recommends IVF. Basic medicament used for ovarial stimulation before the oocyte retrieval is FSH (follicle-stimulating hormone). Which medicament is aditionally given 36 hours before the oocyte retrieval?

HCG.

Correct answer

HCG is standardly used to induct ovulation before oocytes retrieval in almost every protocol. Common dose is 5000 - 10000 IU. Term of hCG application is based on US, size of dominant follicle is expected to be 16 mm. After giving hCG, the vasoactive mediators - mostly VEGF - are released.


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Progesteron.

Wrong answer

Progesterone is used to support luteal phase after embryo transfer - vaginally 3x200mg or i.m. 60mg daily, usually for 2 weeks. The alternative hCG 1500 IU every two days is not recommended because the risk of OHSS.


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17β-estradiol.

Wrong answer

17β-estradiol is used during the embryo transfer when the cycle is supplemented by hormones – f.e. polycystic ovary syndrom, or when the oocytes are donated. The dosage is 3x2mg p.o. or 100µg transdermally, afterwards it is necessary to control the thickness of endometrium by USG. The moment the thickness of endometrium is over 7mm, progesteron is added.


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HCG - human chorionic gonadotropin
OHSS - ovarian hyperstimulation syndrome
IVF - in vitro fertilization
VEGF - vascular endothelial growth factor×
 
RR

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HR

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SpO2

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BP

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ECG

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Gly

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ABG

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CBC

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biochemistry

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