The role of autonomic neuropathy in predicting ovarian hyperstimulation syndrome

Background: Ovarian hyperstimulation syndrome (OHSS) is a life-threatening iatrogenic complication of ovarian stimulation during the assisted reproductive technique. Objective: This study was aimed to elucidate the effect of autonomic neuropathy on the occurrence of OHSS during assisted reproductive techniques. Materials and Methods: One hundred subfertile women underwent ovarian stimulation. The ovarian response was diagnosed by hormone concentrations and vaginal ultrasound. Autonomic function tests were done for all patients using Ewing's protocol. Results: Twenty-eight percent of subfertile women involved in this study had autonomic neuropathy. Out of 100 infertile women undergoing ovarian stimulation, only 5 (5%) had been developed OHSS, all of them had autonomic neuropathy (P < 0.05). The sensitivity and specificity of the autonomic neuropathy for the occurrence of OHSS was 100% and 58% which was insignificant (P > 0.05). The best cutoff score associated with OHSS was ≥1.5 which detected from receiver operating characteristic curve. The odds ratio for the absence of OHSS in patients without neuropathy was 9.891, which was significant as compared with the patients with neuropathy (P < 0.05). Conclusion: The study concludes that ovarian stimulation may cause autonomic function disturbance which can predict OHSS.