Diosmin Succeeded in Preventing Ovarian Hyperstimulation Syndrome in Study

The Potential of Diosmin in Treating OHSS

OHSS is a potentially life-threatening complication of assisted reproductive techniques. It is induced by exogenous or endogenous gonadotropin following controlled ovarian stimulation, which is undertaken before oocyte retrieval. Mild forms of OHSS are self-limiting complications that the body usually resolves within a few days. In contrast, severe OHSS, with an incidence ranging from 0.1 to 3%, requires intensive therapy as it is associated with risks of thromboembolism, respiratory or renal failure, ovarian rupture, and bleeding.

The pathophysiological basis of OHSS is similar to the mechanism of capillary leak syndrome (CLS), which is known as a complication of sepsis. An important role in OHSS is the activation of the vascular endothelial growth factor (VEGF) system. Diosmin, as a vascular protective agent with an effect on stabilizing capillaries, contributes to the normalization of capillary wall permeability and increases natural resistance in microcirculation. Chinese experts in reproductive medicine hypothesized that administering tablets containing diosmin could reduce the incidence and/or severity of OHSS. The hypothesis was tested on a group of women known to have a high risk of this complication.

Reducing the Incidence and Severity of OHSS

This was a retrospective randomized study that analyzed data of women who underwent IVF procedures from September to December 2016 at a reproductive center in Guangzhou, China. The inclusion criterion was the previous cancellation of embryo transfer due to high risk of OHSS following oocyte retrieval. Women were divided into two groups based on whether they received oral diosmin at a dose of 1000 mg twice a day for 10 days after oocyte retrieval, or whether they did not receive diosmin at all. Of the total 146 enrolled patients, 74 used diosmin and 72 were treated without diosmin. The treatment protocol was otherwise identical for both groups.

The incidence of moderate to severe OHSS was 6.2% in the diosmin group compared to 13.4% in the control group (p = 0.027). In the control group, 4 patients required ascites puncture, whereas none in the diosmin group did. None of the patients using diosmin developed severe OHSS.

Conclusion

This monocentric study observed a reduced incidence of moderate to severe OHSS and a reduction in its severity in women at high risk of OHSS with oral administration of diosmin.

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Source: Li T., Zhu W., Liu G. et al. Diosmin for the prevention of ovarian hyperstimulation syndrome. Int J Gynaecol Obstet 2020 May; 149 (2): 166–170, doi: 10.1002/ijgo.13100.