C-reactive protein response is higher in early than in late ovarian hyperstimulation syndrome

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Korhonen , K V M , Savolainen-Peltonen , H , Mikkola , T S , Tiitinen , A E & Unkila-Kallio , L S 2016 , ' C-reactive protein response is higher in early than in late ovarian hyperstimulation syndrome ' , European Journal of Obstetrics, and Gynecology ,and Reproductive Biology , vol. 207 , pp. 162-168 . https://doi.org/10.1016/j.ejogrb.2016.10.051

Title: C-reactive protein response is higher in early than in late ovarian hyperstimulation syndrome
Author: Korhonen, Kati V. M.; Savolainen-Peltonen, Hanna; Mikkola, Tomi S.; Tiitinen, Aila E.; Unkila-Kallio, Leila S.
Other contributor: University of Helsinki, Clinicum
University of Helsinki, Clinicum
University of Helsinki, Clinicum
University of Helsinki, Clinicum


Date: 2016-12
Language: eng
Number of pages: 7
Belongs to series: European Journal of Obstetrics, and Gynecology ,and Reproductive Biology
ISSN: 0301-2115
DOI: https://doi.org/10.1016/j.ejogrb.2016.10.051
URI: http://hdl.handle.net/10138/231673
Abstract: Objectives: Many in vitro fertilization (IVF) complications are inflammatory by nature, some of which are even life-threatening. We evaluated the response of C-reactive protein (CRP) in IVF complications, especially in early and late ovarian hyperstimulation syndrome (OHSS), to support clinical decision making in gynecological emergency policlinics. Study design: In a prospective two-year study at Helsinki University Hospital, Finland, we recruited patients with IVF complications including moderate or severe OHSS (n = 47 patients: 36 early and 14 late OHSS cases), or other IVF complications (n = 13). As controls, we recruited women in an uncomplicated IVF cycle (n = 27). Serial blood samples (CRP, blood count, platelets, albumin, estradiol, creatinine, and electrolytes) were collected from patients upon admission to the emergency polyclinic and during and after treatment on the ward, and from the controls prior, during, and after the IVF protocol. All samples were categorized according to oocyte pick-up (OPU). The statistics included comparisons between and within the study groups, and receiver-operating characteristic (ROC) curve analysis for diagnostic accuracy of CRP for early OHSS at emergency polyclinics. Results: On admission, CRP did not differentiate OHSS from other IVF complications, but CRP was higher in early (median 21; IQR 8-33 mg/L) than in late (6; 3-9 mg/L, p = 0.001) OHSS. In ROC analysis for CRP (12 mg/L), the area under the curve (AUC) was 0.74 (p = 0.001) with sensitivity of 69% and specificity of 71% for early OHSS. CRP was significantly higher (28; 10-46 mg/L) in patients with early OHSS two days after oocyte pick-up (OPU) than in the controls (5; Conclusions: Early OHSS associates with a distinct rise in CRP level beyond that induced by uncomplicated oocyte pick-up, whereas the CRP levels in late OHSS are comparable to those in the control cycles. CRP identifies, but cannot distinguish IVF complications. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
Subject: Acute-phase proteins
Infection
Infertility
Inflammation
Reproductive techniques
LESS SYSTEMIC INFLAMMATION
SYNDROME OHSS
AGONIST
SERUM
IVF
COMPLICATIONS
GONADOTROPIN
PREVENTION
WOMEN
3123 Gynaecology and paediatrics
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