Fibrinogen and cytokines as biomarkers of ovarian hyperstimulation syndrome in women undergoing assisted reproductive technology treatment: A prospective cohort study
Bibliographic record
Abstract
Abstract Background Ovarian hyperstimulation syndrome (OHSS) is the most severe and life-threatening iatrogenic complication of ovulation induction during assisted reproductive technology (ART) procedures. However, the pathogenesis is not yet fully understood. In Ghana, there is a paucity of data on OHSS. For the first time, this study assessed fibrinogen and cytokines, including interleukin (IL)-8, Tumor necrosis factor (TNF)-α, and IL-10, before and after controlled ovarian stimulation (COS) among women undergoing in vitro fertilization (IVF) treatment. Methods This prospective cohort study included 46 women who underwent IVF from April to November 2023 at Hallmark Medicals, Kumasi, Ghana. All participants received the standard treatment protocol for controlled ovarian stimulation (COS) using the long gonadotropin-releasing hormone analog (GnRHa) protocol. A well-structured questionnaire was used to gather sociodemographic and clinical information. Approximately 10 ml of venous blood was collected for laboratory analyses of fibrinogen and cytokine markers as well as hepatic and renal function tests. Statistical analyses were performed in R Language 4.3.2 and SPSS 26.0. A p value < 0.05 was considered to indicate statistical significance. Results The incidence of OHSS among women who underwent controlled ovarian stimulation was 10.9%. It was more prevalent in younger patients aged 18–24 years (60.0%) (p > 0.05). There were no significant differences between OHSS subjects and non-OHSS subjects in terms of pre- and post-COS levels of fibrinogen, TNF-α, IL-8 or IL-10 (p > 0.05). Moreover, there were no significant differences between OHSS and non-OHSS subjects in terms of pre- and post-COS levels of liver and renal function markers (p > 0.05). At a cutoff of ≥ 33.5 ng/L, IL-10 was the best marker for detecting OHSS, with a sensitivity of 80.0%, specificity of 71.8%, and area under the curve of 63.3%. Conclusion The prevalence of OHSS among younger women who undergo controlled ovarian stimulation is high (10.9%). Controlled ovarian stimulation did not alter hepatic or renal function. IL-10 could serve as a diagnostic biomarker for detecting OHSS among women undergoing controlled ovarian stimulation with high sensitivity, specificity and accuracy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".