Risiken der ovariellen stimulation zur IVF

This text aims at reviewing proposed and proven risks associated with ovarian stimulation for IVF. A Medline search was performed and relevant studies are selectively cited. The risk of adnexal torsion, ovarian hyperstimulation syndrome (OHSS), thrombosis and embolism, epigenetic alterations, prion transmission via urinary gonadotrophins and cancer are summarized and discussed. The incidence of adnexal torsion, OHSS and thrombosis after ovarian stimulation for IVF has been determined in large, but heterogeneous populations. For patient counseling, individual risk factors should be taken into consideration. The contention of a risk of epigenetic alterations caused by ovarian stimulation is not supported by sound clinical data. No case of prion transmission from urinary derived gonadotrophins has been observed, therefore, this risk has to be considered theoretical. A relationship between ovulation-inducing drugs and increased cancer incidence has been suggested by a number of studies, however, a causal association has not yet been demonstrated.