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Lookup NU author(s): Emeritus Professor John Davison, Professor Peter Baylis, Professor Alison Murdoch
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Objective: To test the hypothesis that decreases in and maintenance of a new steady state in plasma osmolality and sodium level in ovarian hyperstimulation syndrome (OHSS) are due to altered osmoregulation of arginine vasopressin secretion and thirst. Design: Prospective study. Setting: IVF-ET program in a university-based assisted reproductive treatment center. Patient(s): Eight women undergoing superovulation for IVF-ET and five women with normal menstrual cycles. Intervention(s): Two-hour infusion of 5% saline on day 3 or 4 after hCG administration in patients undergoing IVF or in the early luteal phase in controls. A 5% saline infusion test was done on day 10 after hCG administration in one patient with OHSS and one patient without OHSS, both of whom were undergoing IVF. Main Outcome Measure(s): Comparison of changes in thresholds for thirst and plasma vasopressin to plasma osmolality. Changes in urine osmolality, plasma electrolytes, hemoglobin level, and hematocrit were assessed at baseline and during infusion of 5% saline. Result(s): The sensitivity of the changes in arginine vasopressin secretion and thirst after 5% saline infusion was similar in IVF patients on day 3 or 4 after hCG and controls. However, the osmotic threshold was significantly lower by 6 mOsm/kg in IVF patients. By day 10 after hCG, the lower osmotic thresholds for arginine vasopressin secretion and thirst persisted in OHSS, although the sensitivity to arginine vasopressin secretion was markedly reduced. Conclusion(s): The osmotic thresholds for arginine vasopressin secretion and thirst are reset to lower plasma osmolality during superovulation for IVF-ET. This new lower body tonicity is maintained until at least day 10 after hCG in OHSS. Decreases in plasma osmolality and plasma sodium levels in OHSS are due to altered osmoregulation rather than electrolyte losses; correction of apparent 'electrolyte imbalance' in OHSS is therefore inappropriate. Copyright © 2001 American Society for Reproductive Medicine.
Author(s): Evbuomwan IO, Davison JM, Baylis PH, Murdoch AP
Publication type: Article
Publication status: Published
Journal: Fertility and Sterility
Year: 2001
Volume: 75
Issue: 5
Pages: 933-941
Print publication date: 01/05/2001
ISSN (print): 0015-0282
ISSN (electronic): 1556-5653
Publisher: Elsevier
URL: http://dx.doi.org/10.1016/S0015-0282(01)01704-6
DOI: 10.1016/S0015-0282(01)01704-6
PubMed id: 11334905
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