ABSTRACT
AIMS: To evaluate the incidence of pericardial irritation in females after hormonal stimulation in in vitro fertilization program, and to set its clinical significance as a symptom of ovarian hyperstimulation syndrome (OHSS). PATIENTS: Thirty-nine females, aged 30 +/- 5 years (20-46), with a normal echo finding prior to hormonal stimulation. METHODS: Serial echocardiography: baseline A, in hCG application B, embryo-transfer C. RESULTS: Thirty-nine, 39, and 35 echocardiography examinations were done on A, B, and C respectively. On B, in 7 (17.9%) of 39 patients either new pericardial effusion "1," increased pericardial echogenicity "2," or both "3" were detected (4 patients, 2 patients, and 1 patient, i.e., 10.3%, 5.1%, and 2.6% respectively.). On C, in 8 of 35 patients (22.8 %) abnormalities were detected: "1" in 2 patients (5.7 %), "2" in 1 patient (2.9 %), and "3" in 5 patients (14.2 %). No clinical symptoms related to these findings were present. No OHSS occurred in these patients. On the contrary, clinical OHSS developed later in 2 patients, classified as medium degree (1 patient) and severe degree (1 patient)-both patients had negative echo during follow-up. CONCLUSION: Echocardiographic signs of mild pericardial irritation may appear also in patients with no clinical signs of OHSS. The incidence of these changes increases during stimulation procedure. Development of OHSS may not be preceded by the incidence of these warning signs. Consequently, routine echocardiographic examination during stimulation is not indicated, since significant pericardial effusion is rather a late sign of OHSS.
