卵巢过度刺激综合征：病理生理学与预防。
Ovarian hyperstimulation syndrome: pathophysiology and prevention.
机构信息
Departamento de Ginecologia e Obstetrícia da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (DGO-HC-FMRP-USP), Avenida dos Bandeirantes 3900, 8 masculine andar, Ribeirão Preto, São Paulo, Brazil, CEP 14049-900.
出版信息
J Assist Reprod Genet. 2010 Feb;27(2-3):121-8. doi: 10.1007/s10815-010-9387-6. Epub 2010 Feb 6.
Abstract
PURPOSE
To review and discuss the pathophysiology and prevention strategies for ovarian hyperstimulation syndrome (OHSS), which is a condition that may occur in up to 20% of the high risk women submitted to assisted reproductive technology cycles.
METHODS
The English language literature on these topics were reviewed through PubMed and discussed with emphasis on recent data.
RESULTS
The role of estradiol, luteinizing hormone, human chorionic gonadotropin (hCG), inflammatory mediators, the renin-angiotensin system and vascular endothelial growth factor is discussed in the pathophysiology of OHSS. In addition we consider the prevention strategies, including coasting, administration of albumin, renin-angiotensin system blockage, dopamine agonist administration, non-steroidal anti-inflammatory administration, GnRH antagonist protocols, reducing hCG dosage, replacement of hCG and in vitro maturation of oocytes (IVM).
CONCLUSIONS
Among the many prevention strategies that have been discussed, the current evidence points to the replacement of hCG by GnRH agonists in antagonist cycles and the performance of IVM procedures as the safest approaches.
摘要
目的
回顾和讨论卵巢过度刺激综合征（OHSS）的病理生理学和预防策略，该综合征可能发生在高达 20%接受辅助生殖技术周期的高危女性中。
方法
通过 PubMed 回顾了这些主题的英语文献，并重点讨论了最近的数据。
结果
讨论了 OHSS 的病理生理学中雌二醇、黄体生成素、人绒毛膜促性腺激素（hCG）、炎症介质、肾素-血管紧张素系统和血管内皮生长因子的作用。此外，我们还考虑了预防策略，包括滑行、白蛋白给药、肾素-血管紧张素系统阻断、多巴胺激动剂给药、非甾体抗炎药给药、GnRH 拮抗剂方案、降低 hCG 剂量、hCG 替代和卵母细胞体外成熟（IVM）。
结论
在讨论的众多预防策略中，目前的证据表明，拮抗剂周期中 hCG 被 GnRH 激动剂替代和进行 IVM 程序是最安全的方法。
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Fertil Steril. 2010 Jun;94(1):189-93. doi: 10.1016/j.fertnstert.2009.02.090. Epub 2009 Apr 18.
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