Severe ovarian hyperstimulation syndrome: is it really preventable by prophylactic intravenous albumin?

Objective: To evaluate the effectiveness of TV albumin in preventing severe ovarian hyperstimulation syndrome (OHSS) in patients at risk. Design: Retrospective review and data analysis. Setting: University-based tertiary referral center for assisted reproductive technologies (ART). Patient(s): Sixty women at high risk of developing severe OHSS after superovulation for ART. Intervention(s): One liter of albumin (4.5%) administered IV during oocyte retrieval and immediately afterward. Result(s): Of the 60 women who had prophylactic IV albumin, 5 (8%) developed severe OHSS, which led to hospitalization. Eight (13%) developed moderate OHSS. Forty-seven (78%) did not develop any symptoms. Four of the 5 women who developed severe OHSS had ET and 3 of them (75%) were pregnant (1 twin and 2 singletons). Conclusion(s): Intravenous albumin administered at oocyte retrieval does not prevent the occurrence of severe OHSS, especially in cases associated with pregnancy. It is important that clinicians are not lured into a false sense of security by the early report, full of promise, on the use of TV albumin to prevent severe OHSS. (C) 1997 by American Society for Reproductive Medicine.