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Journals / Journal of the Turkish-German Gynecological Association / 2007 / Cilt: 8 - Sayı: 4

Folikül aspirasyonu, ciddi ovaryen hiperstimülasyon sendromuna karşı koruyucu mu?

Is follicular aspiration preventive for severe ovarian hyperstimulation syndrome?

Cihat ÜNLÜ
Cem DEMİREL
Kaan AYDOS
Ilgın TÜRKÇÜOĞLU
Cem Somer ATABEKOĞLU
Pages
392–396
Publication Date
2022-10-18
DOI
—
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Discussion: Our results indicate that severe OHSS incidence tend to be higher in group without follicular aspiration, but it’s not statistically significant.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: To evaluate the practice of follicular aspiration in prevention of severe ovarian hyperstimulation syndrome (OHSS) in couples with nonobstructive azoospermia stimulated for intracytoplasmic sperm injection (ICSI) and testicular sperm extraction (TESE) without success in obtaining sperm with the TESE.
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Key Findings & Data:Thirty-two stimulated patients in whom follicular aspiration was not performed since no sperm was found in the TESE and 28 stimulated patients in whom follicular aspiration was performed but no fertilization was achieved were conducted as study and control group respectively.
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Conclusion & Impact:Discussion: Our results indicate that severe OHSS incidence tend to be higher in group without follicular aspiration, but it’s not statistically significant.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Objective: To evaluate the practice of follicular aspiration in prevention of severe ovarian hyperstimulation syndrome (OHSS) in couples with nonobstructive azoospermia stimulated for intracytoplasmic sperm injection (ICSI) and testicular sperm extraction (TESE) without success in obtaining sperm with the TESE. Materials and Methods: Couples infertile due to non-obstructive azoospermia were evaluated retrospectively. Thirty-two stimulated patients in whom follicular aspiration was not performed since no sperm was found in the TESE and 28 stimulated patients in whom follicular aspiration was performed but no fertilization was achieved were conducted as study and control group respectively. The patients were evaluated by age, ultrasonographic appearance of the ovaries, induction period, total gonadotrophin dose, estradiol level on the day of human chorionic gonadotrophin (hCG) and the number of follicles with greater than a 15 mm diameter for the risk of OHSS. Controlled ovarian hyperstimulation (COH) was performed with midluteal long gonadotrophin releasing hormone agonist protocol (leuprolide acetate 500 g/day, hMG/FSH 225 IU/day). The severe early OHSS rates of the two groups were compared. Results: There is no patient, has complication with OHSS in group with follicular aspiration, whereas three patients (9.4%) had severe OHSS in group without follicular aspiration. Although, severe OHSS incidence was not statistically different between the two groups (p=0.241), follicular aspiration decreased the severe OHSS incidence (OR: 0.509; 95% CI: 0.394-0.657). Discussion: Our results indicate that severe OHSS incidence tend to be higher in group without follicular aspiration, but it’s not statistically significant. Follicular aspiration may be planned individually especially for patients having high risk for OHSS. Further studies with larger cohorts are needed to investigate the impact of follicular aspiration in prevention of OHSS.

Özet

Amaç: Non-obstrüktif azoospermi nedeni ile intrasitoplazmik sperm enjeksiyonu (ICSI) ve testiküler sperm ekstraksiyonu (TESE) planlanan ve kontrollü ovaryen hiperstimülasyon uygulanan fakat TESE’de sperm bulunmayan infertil çiftlerde ciddi OHSS’yi engellemede folikül aspirasyonun yerini belirlemek.Materyal ve Metot: Non-obstrüktif azoospermili infertil çiftler retrospektif olarak değerlendirildi. Kontrollü ovaryen hiperstimülasyon uygulanmış fakat TESE’de sperm bulunamadığı için folikül aspirasyonu yapılmamış 32 hasta ile kontrollü ovaryen hiperstimülasyon uygulanmış, folikül aspirasyonu yapılmış ancak fertilizasyon elde edilememiş 28 hasta sırası ile çalışma ve kontrol gruplarına dahil edildi. Hastalar ovaryen hiperstimülasyon sendromu (OHSS) riski açısından yaş, overlerin ultrasonografik görünümü, indüksiyon süresi, toplam gonadotropin dozu, insan koryonik gonadotropininin (hCG) gününde östradiol seviyesi ve çapı 15 mm’nin üzerindeki toplam folikül sayısı ile değerlendirildi. Kontrollü ovaryen hiperstimülasyon ortalüteal uzun gonadotropin salgılayıcı hormon agonisti (löprolid asetat 500 μg/gün, hMG/FSH 225 IU/gün) protokolü ile uygulandı. Gruplar arasında ciddi erken OHSS oranları karşılaştırıldı. Sonuçlar: Folikül aspirasyonu yapılan grupta hiçbir hasta ciddi OHSS ile komplike olmazken, folikül aspirasyonu yapılmayan grupta üç hastada (%9.4) ciddi OHSS tespit edildi. iki grup arasında ciddi OHSS oranları açısından istatistiksel olarak anlamlı bir farklılık bulunmasa da (p=0.241), folikül aspirasyonu ciddi OHSS oranını düşürmüştür (OO: 0.509; %95 GA: 0.394-0.657). Tartışma: Çalışmamızda ciddi OHSS oranı, folikül aspirasyonu yapılmayan grupta daha yüksek olarak tespit edilse de istatistiksel olarak anlamlı bir fark bulunmamıştır. Folikül aspirasyonu, özellikle OHSS riski yüksek hastalarda planlanabilir. Folikül aspirasyonunun OHSS’yi engellemedeki yerini belirlemek için daha fazla hasta ile yapılmış çalışmalara ihtiyaç vardır.

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Cite This Article

ÜNLÜ, C., DEMİREL, C., AYDOS, K., TÜRKÇÜOĞLU, I., ATABEKOĞLU, C. S. (2022). Folikül aspirasyonu, ciddi ovaryen hiperstimülasyon sendromuna karşı koruyucu mu?. Journal of the Turkish-German Gynecological Association, Cilt: 8 - Sayı: 4, 392–396. https://ajindex.com/articles/567969

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