Rizikové faktory vzniku ovariálního hyperstimulačního syndromu v programu asistované reprodukce.
| Title in English | Risc factors of ovarian hyperstimulating syndrome in asisted reproduction. |
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| Authors | |
| Year of publication | 2004 |
| Type | Article in Periodical |
| Magazine / Source | Praktická gynekologie |
| MU Faculty or unit | |
| Citation | |
| Web | none |
| Field | Gynaecology and obstetrics |
| Keywords | rixs factors; ovarian hyperstimulating syndrom |
| Description | BACKGROUND: Aim of this study is to define the risk factors of ovarian hyperstimulation syndrome onset during assisted reproduction treatment using in vitro fertilization (IVF) technique. Exploratory computer analysis of electronically stored data about assisted reproduction treatment cycles in clinical registry with the use of data mining system SHLUK. Aquired data processing with the ACETN method (Frequency of Failure Analysis). MATERIALS: Analyzed file included data of 12 527 monitored ART cycles in Dept. of Gynecology and Obstetrics, Masaryk University, Brno since 1989 to 2003. Cycles which leaded to development of ovarian hyperstimulation syndrom (OHSS) were analyzed (2456 cases, 19,6 % of cycles). The incidence of serious OHSS (614 cases, 4,9 %) and critical OHSS (488 cases, 3,9 %) is 8,8 % all together. The incidence of low and middle stage of OHSS has been 10,8 % from all stimulated IVF cycles. METHODS: Both the OHSS complicated cases and cases without ovarian hyperstimulation were tested by data mining ACETN method which is designed to find statistically significant differences among input attributes of ovarian stimulation phase of ART cycles. The observed differences between input attributes were statistically tested and the value of statistical significance was evaluated. RESULTS: Significantly higher incidence of a clinically important form of ovarian hyperstimulation syndrome development during the treatment course of assisted reproduction was observed among patients under 30 years old who were affected by OHSS in previous treatment cycles. We can predict a higher risk of OHSS development in patients with oligomenorrhoea and in cases of immunological and andrological sterility factor. Higher incidence of clinically significant form of OHSS is noticed with stimulation protocols with highly effective gonadotrophine hormones (hMG/FSH+GnRH-SP/LP, FSH-HP+GnRH-SP/LP, rFSH+GnRH-SP/LP, rFSH+GnRH/ antagonists) where the total dose of gonadotrophins is greater than 1125 IU and maximum 17-beta estradiol levels are greater than 20 nmol/l. CONCLUSIONS: We have proved the applicability of the data mining system SHLUK for the analysis of the risk factors with influence on the ART treatment results. ACETN method (Frequency of Failure Analysis) can be used to define statistically significant relations among all attributes of ovarian stimulation part of ART cycle and to define the risk factors of OHSS occurrence. |