Schröder Annika K, Schöpper Beate, Al-Hasani Saafa, Diedrich Klaus, Ludwig Michael
Division of Reproductive Medicine, Department of Gynaecology and Obstetrics, Medical University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
Eur J Obstet Gynecol Reprod Biol. 2003 Oct 10;110(2):186-9. doi: 10.1016/s0301-2115(03)00273-2.
Five women undergoing intracytoplasmatic sperm injection (ICSI) considered to be at high risk of developing an ovarian hyperstimulation syndrome (OHSS) from March to July 2002 underwent unilateral follicular aspiration.
When >/=15 follicles of 12-15 mm diameter in each ovary and a serum estrodial level >/=2500 pg/ml was present, follicular aspiration was performed unilaterally without hCG administration. Ovarian stimulation was continued for 1-3 days in four women before human chorionic gonadotrophin (hCG) was given. In one woman hCG injection was administered at the evening after unilateral follicular aspiration. The oocyte retrieval from the contralateral ovary was performed 36 h after hCG injection. By unilateral follicular aspiration two to six germinal vesicle (GV) oocytes could be retrieved. After in-vitro maturation of those oocytes ICSI was performed.
In four women one to two oocytes were fertilized and cryopreserved. In one case only one triploid pronucleus (3PN) was observed. At the contralateral ovum-pick up after hCG injection a median of 10 could be retrieved. After transfer of a median of 3 embryos, no pregnancy was achieved. Four of five patients developed a severe OHSS and were hospitalized for a median of 3 days.
Unilateral follicular aspiration and continuation of stimulation therefore can not be recommended for the prevention of OHSS.
2002年3月至7月，5名接受胞浆内单精子注射（ICSI）且被认为发生卵巢过度刺激综合征（OHSS）风险较高的女性接受了单侧卵泡抽吸术。
当每个卵巢中直径12 - 15 mm的卵泡≥15个且血清雌二醇水平≥2500 pg/ml时，在不给予人绒毛膜促性腺激素（hCG）的情况下进行单侧卵泡抽吸术。4名女性在给予hCG前继续卵巢刺激1 - 3天。1名女性在单侧卵泡抽吸术后当晚注射hCG。在hCG注射后36小时从对侧卵巢取卵。通过单侧卵泡抽吸术可获取2至6个生发泡（GV）期卵母细胞。这些卵母细胞体外成熟后进行ICSI。
4名女性中有1至2个卵母细胞受精并冷冻保存。1例仅观察到1个三倍体原核（3PN）。在hCG注射后对侧取卵时，中位数为10个卵母细胞可被获取。在移植中位数为3个胚胎后，未实现妊娠。5名患者中有4名发生了严重的OHSS并住院，中位数为3天。
因此，不推荐采用单侧卵泡抽吸术并继续刺激来预防OHSS。
