Controlled ovarian stimulation leads to cardiovascular changes in patients undergoing in vitro fertilization.

Eur J Obstet Gynecol Reprod Biol

Department of Neurosciences, Reproductive Science and Dentistry, University Federico II, Via Pansini 5, 80131 Naples, Italy. Electronic address:

Published: September 2024

AI Article Synopsis

  • The study aimed to analyze changes in hemodynamics (blood flow and heart function) during controlled ovarian stimulation in women undergoing in vitro fertilization at a hospital in Naples, Italy.
  • It included 68 infertile patients and assessed their cardiovascular parameters at three key time points: baseline, estradiol peak, and embryo transfer day.
  • The results indicated significant changes in cardiac output and stroke volume index at these time points, highlighting the impact of ovarian stimulation on maternal cardiovascular health, particularly in patients at risk of hyperstimulation.

Article Abstract

Objective: To study hemodynamic changes along controlled ovarian stimulation in women undergoing in vitro fertilization.

Study Design: Prospective observational cohort study conducted at Mother and Child Department of University Hospital Federico II, in Naples, Italy, between April 2021 and July 2022. Sixty-eight infertile patients undergoing controlled ovarian stimulation with gonadotropin, antagonist protocol and a fresh embryo transfer were included. Haemodynamic assessment was carried out using UltraSonic Cardiac Output Monitor at baseline (T1), estradiol peak (T2), fresh embryo-transfer day (T3). To evaluate relationships between quantitative variables and groups a Student T test for independent data was assessed. One-way analysis of variance (ANOVA) was used to determine the differences between the means of three time points (T1, T2 and T3) for quantitative variables. A mixed-model analysis of variance (ANOVA) was used to determine the differences between groups, among time points (T1, T2 and T3).

Results: Sixty-eight patients were included. Significant differences over the three time points have been observed for CO (f = 3.78 l/min; p = 0.025), SVI (f = 3.56 ml/m;p = 0.013), and RSVI (f = 4.84 dscm-5 m; p = 0.009). No significant differences in trends have been found between beta hCG positive and beta hCG negative groups. There were no significant differences in maternal hemodynamic parameters at time-point T3 between patients treated with hCG 10,000 UI and with Triptorelin. Patients considered at increased risk of hyperstimulation reported a significant increase in SVI at baseline (26.9 ± 9.0 mL/m vs 21.9 ± 7.0 mL/m; p = 0.010).

Conclusion: According to the results of our study, during controlled ovarian stimulation with antagonist protocol, patients undergo significant changes in maternal cardiovascular parameters over a very short period.

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Source
http://dx.doi.org/10.1016/j.ejogrb.2024.07.003DOI Listing

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