The purpose of this study was to evaluate the effectiveness of combined approach on the prevention of severe @entity43 ( @entity43 ) in high risk @entity1 undergoing controlled ovarian hyperstimulation for IVF. The combined approach consisted of: (1) step-down administration of gonadotropins; (2) lowering the dose of @entity1 chorionic gonadotropin; (3) intravenous albumin infusion at the time of oocyte retrieval and (4) @entity1420 use for luteal support. Total of 87 high risk @entity1 with a serum @entity53 level >11,010 pmol/l or 3000 pg/ml on @entity6740 day were managed by this combined approach and their results were compared with 274 low risk @entity1 . In all high risk @entity1 , the gonadotrophin dose were decreased starting as early as on day 4 of ovarian stimulation as necessary, ovulation was triggered by a decreased @entity6740 dose of 5000-7000 IU according to the level of @entity53 , intravenous infusion of 20% @entity1 albumin, 50-100ml were given just 1h before the oocyte retrieval and luteal support was provided either by 50mg @entity1420 in oil, IM or 600 mg micronized @entity1420 orally or vaginally until the day of beta- @entity6740 determination. All @entity1 were followed by serial ultrasonographic examinations and complete blood count analysis after embryo transfer to detect the early signs of @entity43 and to allow early intervention. Age and duration of @entity249 were similar in both groups. Although the number of gonadotrophin ampoules used (22.7 +/- 4.7 versus 27.8+/-3.7; P<0.05) was significantly lower, @entity53 levels (16,764 +/- 6936 pmol/l versus 8870 +/- 2456 pmol/l; P<0.05) and mean number of oocytes (18.3 +/- 5.9 versus 10.6+/-5.4; P<0.05) were significantly higher in study group. There was no significant difference between groups in terms of the mean number of transferred embryos (3.2 +/- 1.1 versus 3.4+/-1.1) and rate of pregnancies (50.5% versus 40.1%). There was only one moderate and no severe @entity43 case in the high risk group, while five moderate and one severe @entity43 cases developed in the control group consisting of low risk @entity1 . In conclusion, intravenous albumin combined with low dose @entity6740 , early step-down administration of gonadotropins and @entity1420 use for luteal support, so called combined approach, proved to be effective in the prevention of severe @entity43 in documented high risk @entity1 .

Combined approach as an effective method in the prevention of severe XXXX .

@entity43 :: ('MESH:D010051', 'Disease') :: ['ovarian hyperstimulation syndrome', 'OHSS'] @entity1 :: ('9606', 'Species') :: ['human', 'patients'] @entity249 :: ('MESH:D007246', 'Disease') :: ['infertility'] @entity1420 :: ('MESH:D011374', 'Chemical') :: ['progesterone'] @entity6740 :: ('MESH:C538388', 'Disease') :: ['HCG'] @entity53 :: ('MESH:D004958', 'Chemical') :: ['estradiol']
@entity43 :: (MESH:D010051,Disease) :: ['ovarian hyperstimulation syndrome']
