Ovarian hyperstimulation syndrome(OHSS) is the most serious complication of ovaulation induction. However, complete prevention of OHSS is not possible although several methods areused to predict and reduce its occurrence. Endocrine profiles and
ultrasonic follicular monitoring are the mainstays of prediction. The aim of this study is to evaluate the efficacy of intravenous administration of human albumin solution for the prevention of severe OHSS. A prospective, randomized,
placebo-controlled
study comparing the effect of IV administration of human albumin solution versus sodium chloride 0.9% solution at the time of intrauterine insemination(IUI) was performed in patients who are at high risk for the development of severe OHSS during
superovulation. Forty-nin patients undergoing superovulation who had serum E2>2,500pg/ml and/or the number of follicles over 14 mm in diameter ≥20 on the day of human chorionic gonadotropin(hCG) administration were included in this study. After
hCG
administration, patients were randomized to receive IV, either 40g of human albumin diluted in 500ml of sodium chloride 0.9%(n=24) or 500 mL of sodium chloride 0.9%(n=25) at the time of IUI. There were no significant differences between two
groups
comparing serum E2 levels, the total number of follicles (≥14 mm) on the day of hCG administration, total ampules(75 IU) of gonadotropin administered, and the duration of gonadotropin administration. There were no significand differences between
albumin treatment group and control group in clinical pregnancy rate and nultiple pregnancy rate. There was a significantly lower incidence of severe OHSS in albumin treatment group, with 4.2%(1/24) compared with 28.0%(7/25) in control group.
There
were
no side effects due to the use of prophylactic IV albumin adminstration. This study suggests that the administration of human albumin solution may help to prevent the development of severe OHSS in high-risk patients and provide a successful and
more
economical alternative to cancellation of cycles.
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