Efficacy of Gonadotropin Releasing Hormone Antagonist (GnRHant) in Treatment of Severe Ovarian Hyperstimulation Syndrome (OHSS): a Randomized Controlled Trial

Background: The symptoms of ovarian hyperstimulation syndrome (OHSS), an unintentional and possibly lethal side effect of ovarian stimulation in assisted reproductive technology (ART), include rapid movement of fluid from the blood vessels to the space outside the blood vessels and tissue spaces, such as the abdominal cavity and cystic enlargement of the ovaries. Aim: Evaluating the efficacy of the GnRH antagonist (GnRHant) cetrorelix in the treatment of early-onset severe OHSS after controlled ovarian hyperstimulation (COH) versus standard management of OHSS. Patients and Methods: This randomized controlled clinical trial included 60 women who developed early-onset severe OHSS after COH presenting to the casualty/outpatient clinic at Alazhar University. They were split up into two groups at random. Group A received standard management of severe/critical OHSS, and Group B received standard management plus cetrorelix. Results: Although the proportions of women requiring initial paracentesis, elevated serum creatinine, or experiencing oliguria were alike between the two groups, women in Group II (cetrorelix group) demonstrated significantly better outcomes. Specifically, the need for repeat paracentesis, mean serum creatinine levels at 48 hours, and the incidence of persistent oliguria after 48 hours were notably lower in Group II compared to Group I (control group). Moreover, both the average length of hospital stay and the mean time to recovery were significantly shorter among women in the cetrorelix group. Conclusion: Using GnRH antagonist as cetrorelix acetate 0.25 mg SC injection once per day in addition to standard management was an effective therapy in women with early OHSS after controlled ovarian hyperstimulation.