Neutrophil to lymphocyte ratio is superior to platelet to lymphocyte ratio as an early predictor of moderate/severe ovarian hyperstimulation syndrome

Abstract

Ovarian hyperstimulation syndrome (OHSS) is a state of exaggerated inflammatory response during controlled ovarian hyperstimulation (COH). Neutrophil:lymphocyte ratio (NLR) and platelet:lymphocyte ratio (PLR) are known to reflect systemic inflammation. The aim of this study was to investigate whether these inflammatory markers could be used as reliable markers in the early prediction of moderate-to-severe OHSS. The study group consisted of 54 patients who developed moderate-to-severe OHSS and the control group was 54 patients who did not develop OHSS undergoing IVF/ICSI. NLR and PLR were calculated from complete blood counts before the COH. NLR and PLR were significantly elevated in the OHSS group compared with the controls (3.2 ± 0.9 and 182.9 ± 49.8 vs 1.8 ± 0.5 and 160.6 ± 48.5, respectively) (p < 0.05, for all). However, only NLR had positive associations between OHSS risk factors (p < 0.05, for all). NLR was superior to PLR as an early predictor of OHSS with an area under the ROC curve of 0.91 (sensitivity = 85% and specificity = 78%). In conclusion, we found that NLR can be used as an early marker of OHSS.