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Lookup NU author(s): Emeritus Professor John Davison,
Professor Alison Murdoch
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Objective:To investigate the concomitant time courses of the changes in osmolality and calculated blood volume during the genesis of ovarian hyperstimulation syndrome (OHSS) : Prospective longitudinal study. Sett : IVF-ET program in a university-based assisted reproductive technology center. Patient(s): Thirty women undergoing superovulation for IVF-ET. Intervention(s): Blood and urine samples were obtained on seven occasions from the start of FSH stimulation until a pregnancy test. Five women with severe OHSS had daily blood and urine tests during hospitalization. Main Outcome Measure(s): Changes in serum and urine osmolality, serum electrolytes, albumin, hemoglobin, and hematocrit. Result(s): Blood volume in women with OHSS decreased significantly by 20% from days hCG +2 to +4, followed by a sustained increase of 30% above baseline from days hCG +8 to +12. There was no statistically significant change in blood volume in women without OHSS. There was a sharp decrease in serum osmolality in women without OHSS between days 0 and hCG +2, which recovered toward baseline from day 4 after hCG. In women with OHSS, there was an unexpected increase in osmolality of 6 mOsm/kg between days hCG -2 and 0, followed by a decrease of 8 mOsm/kg by day hCG +2; this was sustained until day hCG +12. Patients with OHSS demonstrated a concentration and dilution of their urine during the acute and recovery phases of the syndrome, respectively, despite persistence of the hypoosmolar state. Conclusion(s): Decreased osmolality in severe OHSS is maintained despite significant decreases and increases in blood volume, suggestive of fundamental alterations in osmoregulation. Copyright (C) 2000 American Society for Reproductive Medicine.
Author(s): Evbuomwan IO, Davison JM, Murdoch AP
Publication type: Article
Publication status: Published
Journal: Fertility and Sterility
ISSN (print): 0015-0282
ISSN (electronic): 1556-5653
PubMed id: 10899499
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