The Effect of Controlled Ovarian Stimulation on Kidney Function
Date
2024-07-14
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Abstract
Background: The global prevalence of chronic kidney disease (CKD) is >12% and prevention of CKD is a patient-identified research priority. Exogenous hormones are an important sex-specific risk factor for kidney health in females, however, it is yet unknown how the use of exogenous hormones in controlled ovarian stimulation (COS), commonly utilized in fertility treatment, effects kidney function. This study examined the effect of COS on kidney function outcomes, including measured glomerular filtration rate (mGFR) and albuminuria. Methods: Healthy females planning treatment with COS were recruited from the Regional Fertility Program in Calgary, Canada. Participants were studied immediately prior to initiation of COS treatment, as well as at the peak of COS. On each study day, iohexol was administered to the study participant and subsequent bloods draws were collected at time 60, 120, 150, 180, 210 and 240 minutes. Serum analysis for measurement of iohexol levels for each blood sample was used to calculate the mGFR. Albuminuria was measured via an albumin-creatinine ratio (ACR) in a spot urine sample. Changes in each outcome were assessed with Wilcoxon signed-rank tests. Results: Ten females initiating COS were recruited, with a median(IQR) age of 35(3) years. Most participants were nulliparous (70%), and no participants had a history of diabetes, hypertension, or CKD. Participants reported a wide variety of causes of infertility and 30% had been previously treated with COS treatment. No statistically significant changes in mGFR (p=0.13) and ACR (p=0.37) were identified during COS, though a trend towards an increase in mGFR and a decrease in ACR was demonstrated. Conclusion: Overall, treatment with COS did not result in any changes to kidney function, however this study is likely underpowered. Future studies with larger sample sizes are necessary to elucidate the effect of COS on kidney function, in order to optimize precision care in fertility treatment.
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Keywords
In Vitro Fertilization, Fertility, Oocyte Cyropreservation, Infertility, Controlled Ovarian Stimulation, Kidneys, Glomerular Filtration Rate, Albuminuria
Citation
Kharbanda, S. (2024). The effect of controlled ovarian stimulation on kidney function (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.