The effectiveness of Hespan in reducing the incidence of severe hyperstimulation syndrome in polycystic ovarian disease patients

Objective: Prophylactic IV administration of 6% hydroxyethyl starch solution (HES) has been shown to help in preventing moderate-severe ovarian hyperstimulation syndrome (OHSS) in patients at risk. This prospective study evaluates the effectiveness of HES extended use in preventing severe OHSS in patients with or without Polycystic Ovary Syndrome (PCOS) undergoing assisted reproductive technology. Setting: The study group included 45 patients with PCOS (Group 1) and the control group consisted of 98 non-PCOS patients (Group 2). Materials and methods: Patients in both groups received multiple HES doses to reduce risk of severe OHSS. The inclusion criteria included having serum estradiol (E2) ⩾ 3000 pg/mL and/or ⩾20 total follicles on day of HCG and to have an embryo transfer done. HES (500–1000 cc) was given daily starting on the day of oocyte retrieval for a mean number of 3.2 ± 0.8 days. Results: The percentage of patients who developed severe OHSS requiring pigtail catheter insertion or vaginal aspiration was significantly higher in Group 1 vs Group 2 (15.6% vs. 4.1%, P = 0.017). Conclusion: Prophylactic use of multiple doses of HES appears to be more effective in preventing severe OHSS in non-PCOS patients, but may have limited effect in PCOS patients.