Administration of methylprednisolone to prevent severe ovarian hyperstimulation syndrome in patients undergoing in vitro fertilization

OBJECTIVE: To determine whether administration of methylprednisolone to high-risk women undergoing IVF/ICSI helps reduce the development of OHSS.DESIGN: Retrospective clinical controlled study.SETTING: IVF unit.PATIENT(S): One thousand ten women who underwent IVF/ICSI from January 9, 1997, to December 31, 1999. Ninety-one patients who were at high risk for OHSS were identified by using standard criteria.INTERVENTION(S): Methylprednisolone, 16 mg/d starting on day 6 of the stimulation and tapered after the first pregnancy test (day 13 after embryo transfer).MAIN OUTCOME MEASURE(S): Occurrence of OHSS.RESULT(S): A significantly lower proportion of methylprednisolone recipients than untreated participants developed OHSS (10.0% vs. 43.9%). Treatment recipients had more oocytes retrieved and more embryos fertilized than did untreated participants. Methylprednisolone treatment was equally effective in preventing OHSS in all causes of infertility and was effective independent of the number of IVF trials and pregnancy rates.CONCLUSION(S): Treatment with methylprednisolone appears to reduce the risk for OHSS. This treatment thus helps to avoid hospitalization, reduces cycle cancellations, and improves the cost-effectiveness of IVF cycles.