Ovarian hyperstimulation syndrome (OHSS) is a major complication of controlled ovarian hyperstimulation. This study is aimed to determine the efficacy of a cocktail style treatment by combining GnRH-antagonist, letrozole, and mifepristone on the prevention of ovarian hyperstimulation syndrome (OHSS) in high-risk women. This prospective, randomized controlled clinical trial included 170 women who identified as high risk of OHSS during the ovarian hyperstimulation and underwent cryopreservation

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... whole embryos. On the day of oocyte retrieval, the combination group (89 cases) received 0.25 mg Cetrorelix for three days, 5 mg letrozole for five days, and 50 mg mifepristone for three days, the mifepristone group (80 cases) received 50 mg mifepristone for three days. 156 cases were included in final analysis. The combination group showed significantly decreased incidence of moderate and severe OHSS than mifepristone group (20.5% vs. 42.3%), with remarkably reduced serum estradiol level on hCG+3 and +5 day, decreased ovarian diameter, and shortened luteal phase. Oocyte retrieval number, levels of estradiol on hCG+0 and VEGF, and ovarian diameter on hCG+5 were associated with the severity of the symptoms. In Conclusion, the combination treatment effectively reduce the incidence of moderate/severe OHSS in high-risk women. Clinical trial registration information:Date of registration: 12-27-2017Date of initial participant enrollment: 01-01-2018Clinical trial identification number: ChiCTR-INR-17014174 URL of the registration site: www.chictr.org.cn