OBJECTIVE:

To evaluate the practice of follicular aspiration in prevention of severe ovarian hyperstimulation syndrome (OHSS) in couples with nonobstructive azoospermia stimulated for intracytoplasmic sperm injection (ICSI) and testicular sperm extraction (TESE) without success in obtaining sperm with the TESE.

MATERIALS and METHODS:

Couples infertile due to non-obstructive azoospermia were evaluated retrospectively. Thirty-two stimulated patients in whom follicular aspiration was not performed since no sperm was found in the TESE and 28 stimulated patients in whom follicular aspiration was performed but no fertilization was achieved were conducted as study and control group respectively. The patients were evaluated by age, ultrasonographic appearance of the ovaries, induction period, total gonadotrophin dose, estradiol level on the day of human chorionic gonadotrophin (hCG) and the number of follicles with greater than a 15 mm diameter for the risk of OHSS. Controlled ovarian hyperstimulation (COH) was performed with midluteal long gonadotrophin releasing hormone agonist protocol (leuprolide acetate 500 g/day, hMG/FSH 225 IU/day). The severe early OHSS rates of the two groups were compared.

RESULTS:

There is no patient, has complication with OHSS in group with follicular aspiration, whereas three patients (9.4%) had severe OHSS in group without follicular aspiration. Although, severe OHSS incidence was not statistically different between the two groups (p=0.241), follicular aspiration decreased the severe OHSS incidence (OR: 0.509; 95% CI: 0.394-0.657).

DISCUSSION:

Our results indicate that severe OHSS incidence tend to be higher in group without follicular aspiration, but it’s not statistically significant. Follicular aspiration may be planned individually especially for patients having high risk for OHSS. Further studies with larger cohorts are needed to investigate the impact of follicular aspiration in prevention of OHSS.

Keywords: Follicular Aspiration, Ovarian Hyperstimulation Syndrome, Testicular Sperm Extraction.