Is it really the impact of controlled ovarian hyperstimulation on thyroid function?

To the Editor:

I read with great interest the article by Poppe et al.(1) in which they found that serum TSH and fT4 levels increased 2 weeks after embryo transfer (ET) in both the ovarian hyperstimulation syndrome (OHSS) and no-OHSS groups compared with prestimulation levels and they addressed that controlled ovarian hyperstimulation (COH) had an important impact on thyroid function. They have done a good work. However, we have a question according to their data: is it really the impact of COH on thyroid function?

Endocrine gland – derived vascular endothelial growth factor concentrations in follicular fluid and Serum may predict ovarian hyperstimulation syndrome

To the Editor:

We read with great interest the article of Gao et al. (1). Gao et al. (1) had 17 patients that showed only mild to moderate signs and symptoms of OHSS using Golan classification system (2). A more recent classification reclassified OHSS into two groups (moderate and severe) stressing that mild OHSS signs are seen in most cases of controlled ovarian hyperstimulation that does not require special treatments (3), further reducing their OHSS patients number. Therefore, in the absence of severe OHSS cases, it is possible that the signs and symptoms of OHSS patients in their study may be similar to the non-OHSS group.

Reassurance of safety of letrozole and suggested approaches in controlled ovarian hyperstimulation

To the Editor:

We read the article by Dr. Dickey with interest (1). Although it covers many aspects of ovulation induction and related multiple pregnancies, we believe some points require further comment.