Elter K, Scoccia B, Nelson L R
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Illinois College of Medicine, Chicago, USA.
J Reprod Med. 2001 Aug;46(8):765-8.
Liver dysfunction is a rare complication of severe ovarian hyperstimulation syndrome (OHSS). Based on a MEDLINE search from 1966 to September 2000, we report the second case of liver dysfunction associated with moderate OHSS. In addition, this is the first report of moderate OHSS with serum progesterone levels during the first trimester of pregnancy higher than the upper limit of normal for a third-trimester gestation.
A 33-year-old nulligravida with a history of infertility had previously undergone three failed cycles of assisted reproduction. During her fourth attempt at in vitro fertilization and intracytoplasmic sperm injection, she developed moderate OHSS 11 days after embryo transfer. She was managed on an outpatient basis. Her serum progesterone and liver enzyme levels were significantly elevated, as is unusual for the moderate picture of OHSS in this patient.
Hepatic dysfunction is not limited to the severe forms of OHSS. Liver function should be analyzed even in moderate cases. Further study is needed to understand the role of elevated liver function tests and serum progesterone in the pathogenesis of OHSS.
肝功能障碍是重度卵巢过度刺激综合征（OHSS）的一种罕见并发症。基于对1966年至2000年9月期间MEDLINE数据库的检索，我们报告了第二例与中度OHSS相关的肝功能障碍病例。此外，这是首例妊娠早期血清孕酮水平高于孕晚期正常上限的中度OHSS病例。
一名33岁未孕的不孕女性，此前经历了三次辅助生殖周期均失败。在她第四次尝试体外受精和卵胞浆内单精子注射时，胚胎移植11天后发生了中度OHSS。她在门诊接受治疗。她的血清孕酮和肝酶水平显著升高，这在该患者中度OHSS的表现中并不常见。
肝功能障碍并不局限于重度OHSS。即使是中度病例也应分析肝功能。需要进一步研究以了解肝功能检查和血清孕酮升高在OHSS发病机制中的作用。
