Features of the course of pregnancy in ovarian hyperstimulation syndrome

Background. In vitro fertilization is a way to treat infertility, but it has a fairly common and dangerous complication – ovarian hyperstimulation syndrome, which can affect the development of pregnancy and its outcome.

Objective. The purpose was to analyze the impact of ovarian hyperstimulation syndrome on the course of pregnancy. The study included 123 women who were hospitalized at the Yu. Ya. Gordeev State Clinical Hospital № 1 in 2021-2022. The patients were divided into three groups: the main (n = 43) – women with ovarian hyperstimulation syndrome and after in vitro fertilization; comparison group (n = 40) – women without ovarian hyperstimulation syndrome and after in vitro fertilization; and the control group (n = 40) – women who got pregnant naturally. The patient was interviewed, the impact of pregnancy on the occurrence and development of ovarian hyperstimulation syndrome, the impact of ovarian hyperstimulation syndrome on the course of pregnancy, and the presence of possible complications during pregnancy were assessed.

Results. In the main group, the number of patients with inflammatory diseases of the reproductive system, polycystic ovaries, with tubalperitoneal and endocrine factors of infertility, primary infertility, with repeated in vitro fertilization and repeated pregnancy is greater than in the comparison group. The main group is dominated by working patients with higher education. Pregnant patients are more likely to have moderate to mild ovarian hyperstimulation syndrome than non-pregnant women. Multiple pregnancy contributes to the occurrence of ovarian hyperstimulation syndrome. Ovarian hyperstimulation syndrome contributes to the development of threatened miscarriage, spontaneous abortion, false contractions up to 37 weeks of gestation, premature rupture of membranes, preeclampsia, placental insufficiency, and fetal growth retardation syndrome. Ovarian hyperstimulation syndrome increases the likelihood of early reproductive losses, preterm birth, low birth weight babies, and the likelihood of a caesarean section. Ovarian hyperstimulation syndrome more often develops in women with endocrine or tubal-peritoneal factors of infertility, with primary infertility, repeated pregnancy and repeated in vitro fertilization; in working patients with higher education. Pregnancy reduces the likelihood of developing severe and moderate ovarian hyperstimulation syndrome. Multiple pregnancy contributes to the formation of ovarian hyperstimulation syndrome. Ovarian hyperstimulation syndrome contributes to various complications of pregnancy and increases the likelihood of early reproductive losses, increases the likelihood of preterm birth and low birth weight, and creates an indication for caesarean section.

1. Vasilyeva T. S., Peregontseva N. V. The birth rate and new reproductive technologies in healthcare practice at the municipal level. Vestnik Smolenskoj gosudarstvennoj medicinskoj akademii. 2016; 15 (2): 36-39. (In Russ.)

2. Blumenfeld Z. The Ovarian Hyperstimulation Syndrome. Vitam Horm. 2018; 107: 423-451. DOI: 10.1016/bs.vh.2018.01.018.

3. Nastri C. O., Teixeira D. M., Moroni R. M., et al. Ovarian hyperstimulation syndrome: pathophysiology, staging, prediction and prevention. Ultrasound Obstet Gynecol. 2015; 45 (4): 377-393. DOI: 10.1002/uog.14684.

4. Alekhina A. G., Petrov Yu. A., Blesmanovich A. E. Тоvarian hyperstimulation syndrome in the realities of our time. Zhurnal nauchny`x statej. Zdorov`e i obrazovanie v XXI veke. 2018; 20 (4): 22-26. (In Russ.)

5. Ermolenko K. S., Radzinsky V. E., Khamoshina M. B. Controlled ovarian hyperstimulation in patients with anovulatory infertility participating in in vitro fertilization programs: the less the better? Doctor.Ru. 2017; 9: 69-73. (In Russ.)

6. Petrov Yu. A., Alekhina A. G., Blesmanovich A. E. Ovarian hyperstimulation syndrome in the program of the extracorporal fertilization. Chief physician of the South of Russia. 2019; 2 (66): 41-44. (In Russ.)

7. Saroyan T T. Features of the course of pregnancy in women with severe ovarian hyperstimulation syndrome: Avtoref. dis... kand. med. nauk. M., 2009. 24 p. (In Russ.)

8. Shherbakova L. N., Panina O. B. Reproductive losses in early pregnancy in patients with ovarian hyperstimulation syndrome in the IVF cycle. Vestnik RUDN, seriya Medicina. 2009; 7: 131-136. (In Russ.)

9. Shherbakova L. N. Ovarian hyperstimulation syndrome in the in vitro fertilization program. Clinical course and reproductive losses: Avtoref. dis... kand. med. nauk. M., 2010. 23 p. (In Russ.)

10. Serdyńska-Szuster M., Jedrzejczak P., Ozegowska K., et al. Wyniki połoznicze u kobiet zakwalifikowanych do programu zapłodnienia pozaustrojowego powikłanego zespołem hiperstymulacji jajników [Perinatal outcome among women undergoing in vitro fertilization procedures complicated by ovarian hyperstimulation syndrome. Ginekol Pol. 2012; 83 (2): 104-110.

11. Buca D., D'Antonio F., Liberati M., et al. Ovarian hyperstimulation syndrome and adverse pregnancy outcome. Minerva Obstet Gynecol. 2022; 74 (2): 178-185. DOI: 10.23736/S2724-606X.21.04806-5.

12. Schirmer D. A., Kulkarni A. D., Zhang Y., et al. Ovarian hyperstimulation syndrome after assisted reproductive technologies: trends, predictors, and pregnancy outcomes. Fertil Steril. 2020. 114 (3): 567-578. DOI: 10.1016/j.fertnstert.2020.04.004.