TY  - JOUR
A1  - Vetrivel, Krishnika
A1  - Salejee, Ayesha
A1  - Kharunyam, Bheena
A1  - Dehbi, Hakim-Moulay
A1  - Denaxas, Spiros
A1  - Freemantle, Nicholas
A1  - Al Wattar, Bassel H
KW  - Ovarian hyperstimulation; infertility; prediction; assisted reproduction; systematic review
JF  - F&S Reviews
PB  - Elsevier BV
UR  - https://doi.org/10.1016/j.xfnr.2024.100086
SN  - 2666-5719
N2  - Importance:
Ovarian hyperstimulation syndrome (OHSS) is a common iatrogenic complication of controlled ovarian stimulation (COS) in assisted conception. OHSS can be life-threatening and associated with significant morbidity. Several measures could help prevent OHSS; however, accurate risk prediction remains a challenge to enable early prevention.
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Objective:
To review available prediction models for OHSS in women undergoing assisted conception and to identify the best-performing models for their accuracy, generalizability, and applicability.
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Evidence review:
We searched electronic databases (MEDLINE, EMBASE, and CENTRAL) until October 2023. We included studies reporting on the development or evaluation of models predicting the risk of OHSS outcomes before or during COS among women undergoing assisted conception. We reported on models? discrimination, calibration, type of validation, and any implementation tools for clinical practice.
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Findings:
We screened 5,699 citations and included 14 observational cohort studies reporting on 14 prediction models. The median sample size was 782 participants (range 105?256,381), and the majority of models were developed using logistic regression (13/14, 92.9%). The commonest predictor was maternal age (7/14, 50.0%), followed by number of antral and mature follicles (6/14, 42.9%). Six models were internally validated (6/14, 42.9%), and none were externally validated. Only one model had an implementation platform as a smartphone-based application (1/14, 7.1%). Most of the included studies had an unclear risk of bias (7/14, 50.0%), and only three studies were at low risk (3/13, 21.4%).
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Conclusion and relevance:
There are no clinically appropriate and validated prediction models for OHSS among women undergoing controlled ovarian stimulation. More research is needed to improve their generalizability and applicability into clinical practice.
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PROSPERO:
CRD42024509423
ID  - discovery10205670
IS  - 1
N1  - This version is the author accepted manuscript. For information on re-use, please refer to the publisher?s terms and conditions.
VL  - 6
AV  - restricted
Y1  - 2025/06//
TI  - Predicting the risk of ovarian hyperstimulation syndrome in women undergoing assisted reproductive technology treatments: a systematic review and quality assessment of prediction models
ER  -