Читать книгу Assisted Reproduction Techniques - Группа авторов - Страница 147

All patients undergoing ovarian stimulation, whether to correct anovulation or for assisted reproduction techniques (ART), should of course have a pretreatment ultrasound scan and if polycystic ovaries are detected the dose of gonadotropin lowered (to a starting dose of no more than 50–150 IU depending upon age and other factors).

OHSS is usually associated with the presence of a large number of small to moderate sized follicles (< 14 mm diameter) rather than larger, more mature follicles. When serum estradiol concentrations are 10,000–15,000 pmol/L with 20–30 follicles, the patient is at risk of OHSS. A decision then has to be taken as to whether or not to proceed with oocyte retrieval and then potentially electively cryopreserve any embryos created or decide if it is safe to perform a fresh embryo transfer, with the inherent increased risk of late‐onset and prolonged OHSS. If the serum estradiol concentration becomes greater than 15,000 pmol/L (5,000 pg/ml) with more than 30–40 follicles, the treatment cycle should be canceled.