menotropins and Ascites

Topics: Amenorrhea; Ascites; Cervix Mucus; Chorionic Gonadotropin; Clomiphene; Dose-Response Relationship, Drug; Estrogens; Female; Follicle Stimulating Hormone; Humans; Hypertrophy; Infertility, Female; Injections, Intramuscular; Luteinizing Hormone; Menotropins; Menstruation; Ovary; Ovulation; Pregnancy; Pregnancy, Multiple; Time Factors

Topics: Amenorrhea; Ascites; Chorionic Gonadotropin; Female; Gonadotropins; Gonadotropins, Equine; Gonadotropins, Pituitary; Humans; Hydrothorax; Menotropins; Ovarian Cysts; Ovarian Diseases; Ovulation; Pregnancy; Pregnancy, Multiple; Thrombosis

Human menopausal gonadotropin (hMG, 75 IU/body/day) and a gonadotropin-releasing hormone (GnRH) agonist buserelin (1, 10, 100 microg/kg/day) were simultaneously administered to female rabbits by the subcutaneous route for 7 days, and the effects on organ weights, plasma hormones and weight of ascitic fluid were examined. Treatment with hMG increased the ovarian weight, plasma estradiol and weight of ascites, thus indicating that ovarian hyperstimulation syndrome had been induced. Simultaneous treatment with buserelin decreased the changes induced by hMG. GnRH agonists can thus be surmised to reduce the severity of ovarian hyperstimulation syndrome in the rabbit. However, caution is needed when extrapolating the results of this rabbit model to humans.

Topics: Animals; Ascites; Buserelin; Disease Models, Animal; Dose-Response Relationship, Drug; Drug Therapy, Combination; Estradiol; Female; Gonadotropin-Releasing Hormone; Menotropins; Organ Size; Ovarian Hyperstimulation Syndrome; Ovary; Progesterone; Rabbits; Uterus

The ovarian hyperstimulation syndrome (OHSS) is an iatrogenic, unpredictable and potentially life-threatening complication in patients submitted to pharmacological ovarian stimulation. Information on risk factors, etiopathogenetic mechanisms, prevention strategies and therapeutic management is continuously updated. The present study retrospectively analyzed 123 women affected by different grades of OHSS as a result of pharmacological ovulation induction. Hospital admission was suggested in 14 patients with severe OHSS, whereas patients with moderate or mild OHSS were followed in the out-patient section of our department. The results confirmed the efficacy of the therapeutic scheme adopted. The syndrome is localized to the ovaries at the time that the condition is triggered; when organs different from the ovaries become involved, OHSS assumes systemic aspects. The different clinical signs are the basis of a proposal of a local and systemic classification.

Topics: Adult; Ascites; Chorionic Gonadotropin; Creatinine; Female; Follicle Stimulating Hormone; Gonadotropin-Releasing Hormone; Hematocrit; Humans; Menotropins; Ovarian Hyperstimulation Syndrome; Ovary; Ovulation Induction; Respiratory Distress Syndrome; Retrospective Studies

To investigate the hemodynamic state in the ovarian hyperstimulation syndrome (OHSS) in the rabbit model and to determine the role of angiotensin II in the pathophysiology of this syndrome.. Experimental study.. Physiology laboratory.. Female New Zealand rabbits were studied; 16 rabbits were stimulated with gonadotropins, and 6 were controls. Six of the stimulated rabbits received additional treatment with captopril.. Cardiac index, blood pressure, and heart rate were recorded.. Gonadotropin-stimulated rabbits had significant enlargement of ovaries that was not modified by captopril. Ascites was present in 80% of animals in the OHSS group; captopril significantly decreased the incidence and volume of ascites. The three groups did not differ in blood pressure, heart rate, cardiac index, and total peripheral resistance.. In rabbits with OHSS, ascites are a primary event. Such animals are normotensive and have normal vascular resistance and cardiac index. Angiotensin-converting enzyme inhibition decreases the incidence of OHSS in the rabbit model by 30%, suggesting that angiotensin II may play a role in the formation of ascites.

Topics: Angiotensin II; Animals; Ascites; Blood Pressure; Cardiac Output; Chorionic Gonadotropin; Female; Heart Rate; Hemodynamics; Menotropins; Ovarian Hyperstimulation Syndrome; Ovary; Rabbits

The role of intravenous immunoglobulin (IVIG) in the prevention of severe ovarian hyperstimulation syndrome (OHSS) was evaluated.. Ovarian hyperstimulation was induced in eight rabbits using human menopausal gonadotropin/human chorionic gonadotropin (hMG/hCG) after pretreatment with IVIG (IVIG group) or bovine serum albumin (BSA group). Main outcome measures included (1) signs of OHSS, such as the degree of ascites formation and the increase in body weight; and (2) the degree of ovarian stimulation as reflected by serum sex-steroid hormone levels.. A significantly lower ascites response and a tendency toward a decreased change in body weight were observed in the IVIG group compared to the BSA group. Serum estradiol, progesterone, total protein, and ovarian weights were not statistically different between the two groups.. IVIG prevented severe OHSS in a rabbit model, whereas BSA did not. Further studies are justified in an attempt to clarify the role of the immune system and IVIG in the pathophysiology and prevention of severe OHSS.

Topics: Animals; Ascites; Ascitic Fluid; Blood Proteins; Body Weight; Chorionic Gonadotropin; Cytokines; Estradiol; Female; Immunoglobulins; Menotropins; Ovarian Hyperstimulation Syndrome; Progesterone; Rabbits

Ascites is a clinical manifestation of severe ovarian hyperstimulation syndrome (OHSS) which may complicate the induction of ovulation using exogenous gonadotrophins. In severe OHSS severe ascites may occur and can lead to dyspnoea, abdominal discomfort and oliguria. To relieve ascites paracentesis is performed two to three times weekly as needed. We report three cases where an indwelling peritoneal catheter was used to decrease the need for repeated paracentesis. Under ultrasound guidance a closed system Dawson-Mueller catheter with 'simp-loc' locking design was inserted to allow continuous drainage of the ascitic fluid. A total of 23 l of the ascitic fluid were drained from the first, 20 l from the second and 28 l from the third patient with significant decrease in abdominal discomfort and improvement in the urine output. No complications or adverse reactions were noted. Continuous drainage of the ascitic fluid is efficient. It quickly decreases the abdominal discomfort, improves the urine output and prevents the need for multiple abdominal paracenteses which some patients may require.

Topics: Adult; Ascites; Catheters, Indwelling; Chorionic Gonadotropin; Drainage; Embryo Transfer; Female; Fertilization in Vitro; Humans; Menotropins; Ovarian Hyperstimulation Syndrome; Ovulation Induction; Paracentesis; Peritoneal Cavity

Ovarian stimulation is used to treat female infertility, especially in Black Africa where infertility is considered as shameful. Ovarian stimulation can lead not only to multiple pregnancies but also to severe systemic complications such as the one described in this report. Ovarian stimulation using human menopausal gonadotropin led to ovarian hyperstimulation and multiple organ failure in a 28-year-old Senegalese woman. Symptomatic treatment using corticosteroids, abdominal paracentesis to relieve ascites, and fluid expansion failed. Bilateral ovariectomy was performed resulting in permanent sterility. Ovarian stimulation requires close monitoring by ultrasound visualization and measurement of 17 beta-estradiol to allow early detection of complications.

Topics: Adrenal Cortex Hormones; Adult; Ascites; Drug Monitoring; Estradiol; Female; Fertility Agents, Female; Fluid Therapy; Humans; Infertility, Female; Menotropins; Multiple Organ Failure; Ovarian Hyperstimulation Syndrome; Ovariectomy; Ovulation Induction; Paracentesis

To describe a patient with severe ovarian hyperstimulation syndrome (OHSS) demonstrating a beneficial result of reduction in abdominal ascites with a chest tube placed for bilateral pleural effusions.. Case report.. Academic hospital.. A 28-year-old white female with primary infertility on hMG (Pergonal; Serono Laboratories, Randolph, MA) therapy.. Intravenous fluids, lasix, and albumin were administered for correction of laboratory abnormalities, including hemoconcentration, hypoalbuminemia, and leukocytosis. A chest tube was placed for treatment of pleural effusions.. Laboratory values of hematologic measures and electrolytes. Resolution of pleural effusions and abdominal ascites as determined by chest roentgenogram and physical examination.. Treatment of OHSS with intravenous fluids, lasix, and albumin corrected the hemoconcentration, hypoalbuminemia, and leukocytosis associated with OHSS. Placement of a chest tube corrected the pleural effusions and abdominal ascites.. This case report demonstrates a beneficial result of reduction in abdominal ascites by a chest tube placed for pleural effusions.

Topics: Adult; Ascites; Chest Tubes; Drainage; Female; Fluid Therapy; Humans; Infertility, Female; Menotropins; Ovarian Hyperstimulation Syndrome; Pleural Effusion

The ovarian hyperstimulation syndrome is the most serious complication following ovulation induction. It is assuming greater clinical importance now that the indication for ovulation induction is no longer limited to anovulatory women but expands to other infertility problems. In its most severe manifestation the ovarian hyperstimulation syndrome consists of massive ovarian enlargement with multiple cysts, hemoconcentration, ascites, and pleural and pericardial effusion. There is no specific treatment and a reduction in the incidence of this iatrogenic syndrome can be achieved only by preventive measures.

Topics: Adult; Ascites; Female; Humans; Hypertrophy; Iatrogenic Disease; Menotropins; Ovarian Cysts; Ovary; Ovulation Induction; Pleural Effusion; Syndrome

The effects of pharmacologic doses of gonadotropin-releasing hormone, danazol, and indomethacin on the clinical and endocrinologic features of the ovarian hyperstimulation syndrome were studied in the rabbit. The ovarian hyperstimulation syndrome was induced with Pergonal (75 IU of follicle-stimulating hormone and 75 IU of luteinizing hormone) and a follicle-stimulating hormone-dominant gonadotropin preparation (85 IU of follicle-stimulating hormone and 53 IU of luteinizing hormone). None of the three agents tested were effective in suppressing the ovarian enlargement and ascites formation in these animals. Ascites developed despite quite significant variations in plasma and intraovarian sex steroid hormone and intraovarian prostaglandin F levels induced by danazol and indomethacin. Ascites develops in hyperstimulated women in association with both follicular and luteal hyperstimulation. In contrast, the ascites response in the hyperstimulated rabbit develops in the presence of follicular hyperstimulation alone without a significant degree of luteal hyperstimulation.

Topics: Animals; Ascites; Danazol; Female; Follicle Stimulating Hormone; Indomethacin; Luteinizing Hormone; Menotropins; Ovarian Diseases; Ovarian Follicle; Ovary; Ovulation Induction; Pituitary Hormone-Releasing Hormones; Pregnadienes; Rabbits; Syndrome

An iatrogenic disease resulting from the induction of ovulation is described. It would appear that it is uncommon in southern Africa.

Topics: Adult; Ascites; Female; Humans; Menotropins; Ovarian Diseases; Ovulation Induction; Pleural Effusion

In the rabbit model of the ovarian hyperstimulation syndrome, animals given ovine prolactin with human menopausal gonadotropins (hMGs), as compared to animals receiving hMGs alone, demonstrated an increase in the formation of ascitic fluid, a decrease in mean plasma estradiol, and an increase in the mean plasma progesterone concentrations. The ovarian estradiol and progesterone content reflected that of the peripheral blood. These data suggest that, under the conditions of these experiments, prolactin may play a role in the pathogenesis of ascites formation but not the ovarian enlargement observed in this syndrome. Although the plasma estradiol levels were lower and the progesterone levels were higher in the animals treated with prolactin and gonadotropins, this did not prevent the occurrence of ascites, a cardinal clinical sign of this gonadotropin-induced syndrome.

Topics: Animals; Ascites; Estradiol; Female; Menotropins; Ovarian Diseases; Ovary; Progesterone; Prolactin; Rabbits; Syndrome

A case of severe ovarian hyperstimulation syndrome (OHSS) secondary to human menopausal gonadotropin-human chorionic gonadotropin therapy is presented. Draining 4000 ml of exudate by abdominal paracentesis under real-time B-scan imaging induced a marked improvement in the patient's condition. Fluids from the third space were rapidly excreted, renal function improved, and the patient's weight decreased substantially. The underlying physiologic factors responsible for these changes are discussed. Other modes of treatment, including salt and water restriction and the use of volume expanders and diuretics, had no significant effect on the course of the syndrome. Paracentesis has a definite therapeutic value and is recommended in cases of OHSS with tense ascites.

Topics: Adult; Ascites; Chorionic Gonadotropin; Female; Humans; Menotropins; Ovarian Diseases; Ovulation Induction; Syndrome; Water-Electrolyte Imbalance

A case of hyperstimulation syndrome secondary to Pergonal therapy is presented. Successful management was based principally on severe sodium and fluid restriction without the use of volume expanders. The rationale for this therapeutic approach is presented and discussed. Although this iatrogenic disease should be virtually eliminated with the monitoring of daily urinary estrogens, severe hyperstimulation may still occur as a result of laboratory error.

Topics: Adult; Anuria; Ascites; Cation Exchange Resins; Chorionic Gonadotropin; Diet, Sodium-Restricted; Estrogens; Female; Humans; Hydrothorax; Iatrogenic Disease; Infertility, Female; Menotropins; Oliguria; Ovarian Cysts; Ovarian Diseases; Pregnancy; Stimulation, Chemical; Syndrome; Water Deprivation

Eighteen patients hospitalized for excessive ovarian hyperstimulation syndrome are reported. In 14 cases the ovarian hyperstimulation was induced by human menopausal -onadotropins and in 4 cases by combined treatment with clomiphene and HCG. In 5 patients the hyperstimulation was associated with conception, which resulted in 1 quintuplet delivery, 1 early quintuplet abortion, 1 twin abortion, 1 normal delivery, and 1 missed abortion. The regimen of treatment was a conservative one. The patients were hospitalized and treated with infusion of plasma expanders. Anticoagulant therapy was administered only in cases that showed clinical evidence of thromboembolic pheomena or laboratory evidence of severe hemoconcentration. The pathogenesis of the ovarian hyperstimulation syndrome, prevention, and management are discussed. This syndrome should be diagnosed early and treated intensively.

Topics: Abdomen, Acute; Adult; Anovulation; Ascites; Body Fluids; Chorionic Gonadotropin; Clomiphene; Drug Therapy, Combination; Female; Humans; Iatrogenic Disease; Infertility, Female; Menotropins; Menstruation Disturbances; Ovarian Cysts; Ovarian Diseases; Ovary; Plasma Substitutes; Pregnancy; Pregnancy, Multiple; Stimulation, Chemical; Syndrome

Topics: Adult; Ascites; Female; Humans; Infant, Newborn; Infertility, Female; Male; Menotropins; Ovarian Diseases; Pregnancy; Pregnancy Complications, Hematologic; Pulmonary Embolism; Thrombophlebitis

Topics: Adult; Ascites; Chorionic Gonadotropin; Female; Humans; Hydrothorax; Menotropins; Nausea; Oligomenorrhea; Ovarian Diseases; Vomiting

Topics: Amenorrhea; Ascites; Estrogens; Female; Humans; Infertility, Female; Menotropins; Ovarian Diseases; Ovary; Ovulation; Pregnancy; Pregnancy, Multiple; Stimulation, Chemical; Triplets; Twins; Vaginal Smears