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Dynamic Changes of the Immunoglobulins in Patients with Severe Ovarian Hyperstimulation Syndrome: Efficacy of a Novel Treatment Using Peritoneo‐Venous Shunt
Author(s) -
TAKAMIZAWA SATORU,
SHIBAHARA HIROAKI,
TANEICHI AKIYO,
OBARA HIROMI,
FUJIWARA HIROYUKI,
OGAWA SYUICHI,
KOIKE TOSHIMITSU,
IDEI SADAYOSHI,
SATO IKUO
Publication year - 2002
Publication title -
american journal of reproductive immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.071
H-Index - 97
eISSN - 1600-0897
pISSN - 1046-7408
DOI - 10.1034/j.1600-0897.2002.1o005.x
Subject(s) - ovarian hyperstimulation syndrome , medicine , peritoneal cavity , ascites , paracentesis , antibody , albumin , embryo transfer , gastroenterology , in vitro fertilisation , anesthesia , surgery , pregnancy , immunology , biology , genetics
PROBLEM: To evaluate the efficacy of continuous auto‐transfusion system of ascites (CATSA) for the treatment of patients with severe ovarian hyperstimulation syndrome (OHSS) at the risk of febrile morbidity, the dynamic changes of immunoglobulins in the sera and the peritoneal fluid from patients with severe OHSS treated by CATSA were estimated. METHOD OF STUDY: Ten patients with severe OHSS after superovulation for in vitro fertilization‐embryo transfer (IVF‐ET) were treated by CATSA. Immunoglobulin concentrations were examined in the serum and in the peritoneal fluid before and after CATSA. As controls, serum samples from 15 infertile women, who did not develop OHSS after the same superovulation protocol, were obtained on the day of mid‐luteal period (Control‐1). Serum samples from 15 patients with OHSS, who were treated by albumin infusion without paracentesis, were also obtained before and after the treatment (Control‐2). RESULTS: Before the treatments, serum immunoglobulin G (IgG) concentrations in patients with severe OHSS treated with CATSA and those in patients of Control‐2 were significantly lower than those in patients of Control‐1 ( P < 0.01). Following CATSA, the concentration of IgG increased in the sera, while it decreased in the peritoneal fluid. CONCLUSIONS: Serum IgG in patients with severe OHSS exuded into their peritoneal cavity, indicating that they might be at the status of immunodeficiency and at the risk of febrile morbidity. However, non‐infectious febrile morbidity attributed to endogenous pyrogenic mechanism might be considerable. It is also suggested that CATSA might be effective in improving hypoimmunoglobulinemia of the patients with severe OHSS by the peritoneo‐venous shunt.