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What is the best predictor of OHSS?
Retrospective cohort: > 12,000 cycles
Presence of > 15 follicles: associated with dramatic increase in OHSS risk
29 Tarlatzi T.B., et al. ESHRE, 2014, P245. 30-5-2017
Number of Follicles ≥ 11mm On Day of hCG Can Predict Severe OHSS
AUC = 0.779
1.0 0.9 0.8 0.7 0.6 0.5 0.4 0.3 0.2 0.1 0.0
cut-off ≥ 19 follicles
Sens = 74.3% cut-off ≥ 19 follicles
Large combined dataset n=2,433 patients GnRH-antagonist protocol
35 cases severe OHSS (1.4%) Positive predictive value, 4.1 % Negative predictive value, 99.5 %
Sens = 74.3%
cut-off ≥ 19 follicles
Spec = 75.2%
SpecS=e7n5s.2=%74.3% Spec = 75.2%
0.0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0 1-Specificity
For moderate or severe OHSS, the optimal cut-off point was ≥17 follicles. Sensitivity=68.9% Specificity=66.7% AUC = 0.732.
PPV, 6.0% NPV, 98.6%
Griesinger G, et al. Plos One. 2016.
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Sensitivity