Intravenous albumin administration for the prevention of severe ovarian hyperstimulation syndrome: a systematic review and metaanalysis

Abstract

Objective: To reappraise the currently available evidence, providing the answer to the following question: does intravenous albumin administration reduce the risk of severe ovarian hyperstimulation syndrome (OHSS) occurrence following ovarian stimulation with gonadotrophins and GnRH analogues for IVF in high-risk patients?

Design: Systematic review and metaanalysis.

Setting: University-based hospital.

Intervention(s): Intravenous albumin administration in high-risk patients for prevention of severe OHSS occurrence.

Main outcome measure(s): Severe OHSS occurrence.

Result(s): Eight eligible randomized controlled trials were identified (n=1,199 patients) that offered data for statistical pooling. No statistically significant difference in the occurrence of severe OHSS in patients who received intravenous albumin (n=595) and those who did not (n=604; odds ratio [OR], 0.80; 95% confidence interval [CI], 0.52-1.22) was detected. Moreover, no statistically significant differences were present regarding the probability of pregnancy (OR, 0.83; 95% CI, 0.64-1.07) and first trimester pregnancy loss (OR, 1.44; 95% CI, 0.73-2.85) between patients who received intravenous albumin and those who did not.

Conclusion(s): Based on the currently best available evidence, intravenous albumin administration in high-risk patients does not appear to reduce the occurrence of severe OHSS. This finding should be considered when implementing strategies for severe OHSS prevention.