Comparative Effects of Hydrocortisone, Methylprednisolone, and Dexamethasone on a Rat Model of Severe Ovarian Hyper Stimulation Syndrome

Severe ovarian hyper stimulation syndrome (OHSS) is a gynecological medical emergency that coincides with controlled ovarian stimulation which results in ovarian enlargement and the secretion of vasoactive substances, especially vascular endothelial growth factor. Extravasation of fluid into the third space and the thromboembolic events constituted the most important consequences of the vaso-permeability storm. According to international guidelines, OHSS prevention is recommended through personalized ovarianstimulation and identification of susceptible patients. However, the pharmacological prevention isn’t so far recommended. The current study investigated and compared the effects of hydrocortisone, methylprednisolone, and dexamethasone on severe OHSS rat models. Fifty rats were divided into five groups. Group-I: OHSS-negative control. Group-IIa, (severe OHSS untreated group): rats received 10 IUfollitropin alpha IV for four consecutive days, beginning from the 29th day of life, and 30 IU HCG on day 33. Groups IIb, c, and d received the same ovarian induction regimen as in group IIa combined with intravenous corticosteroids starting from the 29th day for seven days. Group-IIb is the hydrocortisone group, Group-IIc is the methyl prednisolone group, and Group-IId is the dexamethasone group. SevereOHSS induction in rats was evidenced by increased body weight, ovarian weight, serum estrogen level, peritoneal fluid amount, ovulation induction response in ovarian histopathology namely the antral & luteal follicle count, the relative follicle diameter. Hydrocortisone, methylprednisolone, and dexamethasone significantly reduced most of the current study parameters differently. However,methylprednisolone showed more promising effects on OHSS prevention.