Bodri Daniel, Guillén Juan José, Polo Ana, Trullenque Marta, Esteve Carolina, Coll Oriol
Clínica EUGIN, Calle Entença 293-295, 08029 Barcelona, Spain.
Reprod Biomed Online. 2008 Aug;17(2):237-43. doi: 10.1016/s1472-6483(10)60200-3.
A retrospective study was conducted in a private infertility centre to evaluate the rate of complications in a large oocyte donation programme. A total of 4052 oocyte retrievals were performed between January 2001 and October 2007. Altogether, 1238 cycles (30.6%) were stimulated with the use of gonadotrophin-releasing hormone (GnRH) agonists and in 2814 cycles (69.4%) the GnRH antagonist protocol was used. The GnRH antagonist treated cycles were triggered with human chorionic gonadotrophin (HCG) or a GnRH agonist in 1295 and 1519 cycles, respectively. Complications related to oocyte retrieval occurred in 17 patients (0.42%) (intra-abdominal bleeding: n = 14, severe pain: n = 2, ovarian torsion: n = 1). Fourteen of these were hospitalized (0.35%) and six donors (0.15%) required surgical intervention. Pelvic infections, injury to pelvic structures or anaesthesiological complications were not observed in this series. Moderate/severe ovarian hyperstimulation syndrome (OHSS) occurred in 22 donors; 11 required hospital admission and 11 were managed on an outpatient basis. All cases were related to HCG triggering (0.87%). Serious complications related to oocyte retrieval occurred at a low rate in healthy young donors. The risk of OHSS can be substantially reduced by specific stimulation protocols, which include GnRH agonist triggering. Prospective oocyte donors should be adequately counselled about the risks related to egg donation.
在一家私立不孕不育中心进行了一项回顾性研究，以评估大型卵母细胞捐赠项目中的并发症发生率。2001年1月至2007年10月期间共进行了4052次取卵操作。总共1238个周期（30.6%）使用促性腺激素释放激素（GnRH）激动剂进行刺激，2814个周期（69.4%）使用GnRH拮抗剂方案。GnRH拮抗剂治疗的周期分别在1295个和1519个周期中用人绒毛膜促性腺激素（HCG）或GnRH激动剂触发。与取卵相关的并发症发生在17例患者中（0.42%）（腹腔内出血：n = 14，严重疼痛：n = 2，卵巢扭转：n = 1）。其中14例住院（0.35%），6例捐赠者（0.15%）需要手术干预。本系列中未观察到盆腔感染、盆腔结构损伤或麻醉并发症。22例捐赠者发生中度/重度卵巢过度刺激综合征（OHSS）；11例需要住院治疗，11例在门诊处理。所有病例均与HCG触发有关（0.87%）。健康年轻捐赠者中与取卵相关的严重并发症发生率较低。通过包括GnRH激动剂触发在内的特定刺激方案，OHSS的风险可大幅降低。应向潜在的卵母细胞捐赠者充分咨询与卵子捐赠相关的风险。
