[Monitoring of follicles by ultrasonography during induction with HMG-HCG treatment--especially on the prevention of side effects].

Estrogen levels are a useful indicator to use in predicting of ovarian hyperstimulation syndrome (OHSS) which is one of the side effects of HMG-HCG therapy. However, the quantitative assay of estrogens entails cumbersome time-consuming procedures. The present study represents our attempt to establish criteria for predicting the occurrence of OHSS by the use of ultrasonography (USG), a diagnostic procedure that can be performed quickly and conveniently. The subjects were 40 anovulatory women (79 cycles) receiving HMG-HCG therapy. Each patient had USG performed at the time of switching to HCG in a regimen of sequentially administered gonadotropins and was measured for maximum follicular diameter (FD) and total of vertical follicular area (FA) to correlate measurements of these parameters with simultaneously determined serum estradiol (E2) levels. A study was also made of relationships of FD and FA with ovulation and OHSS. The results are summarized as follows: No distinct correlation was observed between FD and E2 (r = 0.3794). It should be noted, however, that the therapy was successful in inducing ovulation in those cases in which the patient was switched to HCG from HMG when FD was 18mm or above. There was a significant correlation between FA and E2 (r = 0.8113, p less than 0.001). FA was thus proven to well reflect E2 levels and hence to be a parameter of the predictive value for OHSS. All but one (with moderate OHSS) of 26 cases showing evidence of OHSS had FA values of more than 6.0cm2, while those developing severe OHSS invariably.(ABSTRACT TRUNCATED AT 250 WORDS)