Bachmakova N V, Dubrovina O S, Lisovskaya T V, Melkozerova O A, Maysina E N, Sentiurina L B
Mother and Child Care Ural Research Institution of Russia Public Health Ministry , Ekaterinburg , Russian Federation and.
Gynecol Endocrinol. 2014 Oct;30 Suppl 1:25-9. doi: 10.3109/09513590.2014.945780.
Known factors of the development of ovarian hyperstimulation syndrome (OHSS) are not informative enough, if considered independently. This is confirmed by the absence of initial predictors in cases of severe OHSS and, in contrast, not clinically apparent manifestations in patients seemingly having high risk of this pathology. These circumstances demand investigation of additional prognostic parameters of the OHSS.
To find out additional OHSS risk factors alongside with the previously known ones in the course of implementation of assisted reproductive technologies (ART) in patients having initial metabolic and hormonal disorders. INVESTIGATION DATA AND METHODS: Retrospective analysis of clinical laboratory and functional parameters of hormonal and metabolic state of 133 women suffering OHSS was held. Classification by Schenker, 1995, was used to detect the diagnosis. Control group consisted of 347 women with the unverified OHSS. Basic and control study groups were similar in age and in number of mild and long protocols of ovarian stimulation held. RESULTS AND THEIR DISCUSSION: A significant correlation dependence was revealed between the fact of the OHSS development and some indicators of hormonal and metabolic state: HOMA index of insulin resistance; thyroid parameters: thyroid stimulating hormone (TSH), free thyroxine (fT4), thyroid peroxidase antibodies (AbTPO); and level of prolactin. The revealed correlation dependence of the OHSS development on the above parameters allows to use them for determination of the OHSS risk group and taking measures to prevent this complication of the ART.
卵巢过度刺激综合征(OHSS)发展的已知因素,若单独考虑,信息并不充分。重度OHSS病例中缺乏初始预测指标,以及相反地,看似有该病症高风险的患者却没有明显临床表现,都证实了这一点。这些情况需要对OHSS的其他预后参数进行研究。
在患有初始代谢和激素紊乱的患者实施辅助生殖技术(ART)过程中,找出除先前已知因素之外的OHSS其他风险因素。
对133例患OHSS女性的激素和代谢状态的临床实验室及功能参数进行回顾性分析。采用1995年申克分类法进行诊断。对照组由347例未确诊OHSS的女性组成。基础研究组和对照组在年龄以及所进行的轻度和长期卵巢刺激方案数量方面相似。
OHSS发生与激素和代谢状态的一些指标之间存在显著的相关性:胰岛素抵抗的HOMA指数;甲状腺参数:促甲状腺激素(TSH)、游离甲状腺素(fT4)、甲状腺过氧化物酶抗体(AbTPO);以及催乳素水平。OHSS发生与上述参数之间所揭示的相关性,使得可以将它们用于确定OHSS风险组,并采取措施预防ART的这一并发症。